1982, 09-27 Permit: 82A-8706 ResidencePLAN NUMB R
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APPLICATION/PERMIT
SPOKANE COUNTY — BUILbING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 -COPIES
1.
2.
3
4.
It41JOB ADDRESS
LOT 'BLOCK SU IVISION
Z f� i � Alpo f r,
OWN R
ADDRNSo10 eci —I-K/V .
ROr
10\t\1
PHO E Q�7
GL Ly i
LEGAL DESCRIPTION - SEE ATTACHED
PARCELNUMBER/S 2-1 G - - 1)17 (m)
PHONE
Actual sI acks in Feet,
North 1 (South 4 / East
Size f ck �2F1 ZSo eIC �fZon
(West d-7
ADDRESS
ZIP
Type onst.
Occupancy
3
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Vali'," 2-4_
Building Area In Sq. Ft.
ADDRESS
ZIP
Upper Floors
i
Garage Atex Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
0 ALT. 0 AD N. 0 RPL. 0 MVE.
LJ BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. lades
Np Rooms
No. cal Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Nqt jYeq'd.
DESCRIBE WCIRK
8. 64\66
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER SEWER
C
Ownership
Public 0 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 APPLICATION
—�— g7
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
+ NAME DATE
'!Aj1llllA 1/11J�
Fire Marshall
Co.,
irr
Utilities
Plans E la.miner ®'
SEPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building z6'
Plumbing
ech
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 2.7O
PERMIT NUMBL,R ���
824 B106
02* *276
*276006
A *27324 8
87052
.09=27—'82
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0119,4'i2a7;;'02;
DATE ISSUED
870:'62 *27'6,000,
PERMIT NO. TOTAL
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