1982, 09-30 Permit: 82A-8937 ResidencePLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JO
AD BESS
A i1'i
LEGAL DESCRIPTION - SEE ATTACHED
3.
LOT
OwW,((��ER
t\4
ADpRE'
G'.
CON
BLO K
SU DIVISION
CeN
5-11Z-
PARCEL NUMBER /S •
2_ i1 -112,104.1
4.
ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
PHONE
ZIP
TO
LJ „NEW El ALT. ❑ AD'N. El RPL. ❑ MVE.
BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
Actual Set Backs in Feet
North i 'South
Size of ParcI
�x 17g
Ty-p@ Jnst.
Valuation
°
ivis.'n Floor
1
cupancy
Upper Floors
Area of Dec s
No. Ba s No. Stories
East West°
Zone CI{�ssification
I N611, , -C2 4 -
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
Storage
Un asement
No. Rooms
No. o
Dwellings
CERTIFICATE
of EXEMPTION
Req'
DESCRIBE WOW
•
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
tom”
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private
,'GSE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIQNS
DATE OF APPLICATION 7,7 SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Health
nning
Fire Marshall
27S'
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
eq'd.
FEES COLLECTED
Single $
Building L!
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
52
PERMIT NURSER
;i► -13-7
02* *25200
*252006
A *000
8'74,52
09- 27-82
z° 64.79
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09- 3Q -82 893.75 *252.000
DATE ISSUED
PERMIT NO. TOTAL
r2.21 QAT. \ 6\
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