1982, 05-17 Permit: 82A-3811 MHPLAN 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
1.
JOB ADDRESS
Al • Ct C.3 B AA -3W\ pq...)
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2. 2.0
BLOCK
4 -
SUBDIVISION
a P. r `a F t
OWNER
3. 'NOEL_
ADDRESS
4.
CONTRACTOR
PHONE
Gtr% -Cicttcrci
ZIP
PARCEL NUMBER/S
3a3\-115.
Actual Set Backs in Feet - t s, -rd rl[ 1
1South East (West
North
PHONE
Size of Parcel Zone Classification
kC�k l7 k� C.CZL
ADDRESS
DDRESS
DESIGNER
5. ADDRESS
ZIP
Type Const.
Occupancy
la -27:75
Sprinklered
❑Yes :No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑{/RPL.
0 MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not geq'd.
DESCRIBE WORK
8. t rwt
Enum. Dist.
ILocation (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership ,...,/
Public 1:1 Private LN'
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 APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
c— v i 4 c C
Planning
Fire Marshall
Co. Engineer
Nc>T (Z. 4
Utilities
Plans Examiner
SEPA Checklist
Building Technician
le-Avcz 26)-79
-- :PLAGE- C> i /I PdulSYr t -S L-0C,r,tTc
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Homf 6o '627
Other (Specify)
TOTAL
$ .60
PERMIT NUMBER
c5.2_ --'t
07* *5000
*50,00
*50.0018
A *000
381.02
05-17-82
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0:5 - 7• 'I- 8 2
3'81.1 z * 5 0.0'0 8.) -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL