1982, 09-30 Permit: 82A-8929 Residence(PLAN 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
4.
JOB 4D
11 ti < DRESS K1`1'SU ",eIP' ,9
IV1s� c ' ' 'r
t
OW
AD RESS
CONT A TO
ADDRESS
PHONE_
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S 1 y'� Kr 4 i
DESIGNER
ADDRESS
PHONE
ZIP
PHONE
ZIP
Actual t Backs in Feet /'
North South ?(i
Size f Parcel ( c
Tup,Cpnst. Occupancy
r.
6.
CHANGE OF USE FROM
TO
TYPE
7. OF
WORK
B NEW ❑ ALT.
CJ BLD. ❑ PLMB.
El AD'N. ❑ RPL. ❑ MVE.
❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
Valuation & o
M�Flgor I Upper Floors
Are,a fDDeck
4k; (
No. Baths No. Stories
'East West
Zone Classification 7S
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area
i
Garage Area
n Sq. Ft.
Storage
Finished Basement
Unfin. B,asement
C-1
No. Rooms
No. of Dwellings
}
DESCRIBE WORK
8.
VALUATIO SOURCE GAS ELECTRIC WATER SEWER
OF G. 5c, L IC-
9. UTILITIES ib f2I . '�,.f
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 INSPECT'', 1
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not Req'
Ownership
Public ❑ Private
USE CODE
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL ■PPROVALS
NAME DATE
Fire Marshall
Co. Ee
Sa-4 Q _
Utilities
Plans Examine
P �
IV
SE A Checklist
e
la
SPECIAL CONDITIONS:
'LAC -'C onK ZI L -2
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
2-
PERMIT NUMBER
e A`6a
u2* *25200
*25'2.00
A *000
849.62
09 -21 ,-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 2
DATE ISSUED
892,92 *252,002p'
PERMIT NO. 1 C
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