1982, 11-29 Permit: 82B-1524 BarnPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY - DEPARTMFNT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
STREET ADDRESS
LO SUBDIVISION %
T T � /6\1\. AC-/7, ��% Ci Fjl/\
BLOCK
PARCEL NO. 26 - 1007
OWN R
3
PHON
PHONE
LEGAL DESCRIPTION:
MAILI G A D ESS® 4_
CONTRACTOR U \
4. G I S L„. r7La -
ADDI1ESS 7: t Iis
ZIP
Actual Set Backs in Feet to:
North 'South 80
East I t
(West
LICENSE EXPIRES
PHONE
Size of Parcel
1'7>, Z,--DI
Z ne Classifice tion
Residential
Commercial ❑
ZIP
Type Cpnst,
Occupancy
Sprin,klered
❑Yes No ❑Req'd.
5.
DESIGNER
PHONE
New Const. Valuation
10,00
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage /Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE C1 NEW ❑ ALT. ❑ AD' N. ❑ RPL.
7. OF
WORK D/BLD. ❑ PLMB. ❑ MECH. El M.H.
8.
9.
DESCRIBE WORK
VALUATION
SOl}RCE
UTILITIES
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required
Received
Yes ❑ No❑
YesE NoEI
Number
Shorelines /Flood Hazard,
Yes❑ Not Applic.
Plans Required ❑
Received 0
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE/
SEPTIC i'
SEWER ❑
Ownership
Public ❑ Private
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 au-
thority 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 INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION _ y
DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Is►v�ir INc/ t1NJfLA 1Li(
X101 M ALL, NAIPA -d
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
3 L✓
TOTAL $
PERMIT NUMB...
,--
"?* *3200
*3200
A *000
14262
1 1 -2 9 -82
2 64 79
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEISSUED3 0 — 8 2
PERMIT1405. 2 4 z
*3200 °H
TOTAL
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Post Falls, Idaho (208)773-5809
Spokane, WA (509) 455-5139
%TORN ARDELLI
Address
- City —
State
County. -- Zip -
• Telhone
---Representative
LEGAL: N.5504 BANNEN
13T2, BLOCK #1
SWAN ACB...,`'S SLU);DIVISION_
PARCEL- #354;
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