1982, 01-22 Permit: 82A-607 InsertPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUiLIiING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
BLOCK
OWNER
SUBDIVISION
3. l�.00,Ee.. t L.1`2 i -'
ADDRESS
E 5
CONTRACTOR
4' ADDRESS
VLA
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
PHONE
ZIP
TO
Ii NEW ❑ ALT. 0AD'N. ❑ RPL. ❑ MVE.
❑ BLD. 0 PLMB. 2 MECH. 0 M.H. 0 POOL
0 OTHER
DESCRIBE WORK
8.jc ;
VALUATION
9.
SOURCE
OF
UTILITIES
AS
•
ELECTRIC
WATER
SEWER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South 'East (West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
Oyes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
No. Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Storage
Unfin. Basement
No. Rooms
Location (Area)
Ownership
Public ❑ Private ❑
USE 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 INSPECTIONS
DATE OF APPLICATIONP& / SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
SEPA Checklist
Bu
(ding Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
FEES COLLECTED
Single $
Building
Plumbing
Mech. 4 2^0- C"
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ `2GJ . CA:"
PERMIT NUMBER
04* *2000
*2000
60.62
01-22-82
22 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
60:72 *20.00°0-1 -
PERMIT NO. TOTAL