1982, 08-03 Permit: 82A-6748 AdditionPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNT; — UUILDING 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.
JOB ADDRESS
£U4- 'W*1N-)O
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
3
LOT
tZ
OWNER
titYSY�.�
SUBDIVISION
PHONE
PARCEL NUMBER/S
s` S- O 7 -
ADDRESS
t 41 -
CONTRACTOR
D . E %-`
2 "(3
zIP G0'3�
Actual Set Backs in Feet
North eck,' 'South (East
f
West se
PHONE
Size of Parcel Zone Classification
ADDRESS
\4 -kc.) -1
ZIP
437
Type Const.
Occupancy
t2. -3
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
V luation
84,32°
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 ❑ ALT. N.
AD N.
iireBLD. ❑ PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
L
No. Rooms
No. oftDwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not €teq'd.
DESCRIBE WORK
8. %�i77�T+t�L1 T V`si��LNc
Enum. Dist. I Location (Area)
9VALUATION
'4,3
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
$EWER
Ownership
Public ❑ Private 1/
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances
type of work will be complied with whether specified herein or not. The granting of a permit d
to give authority to violate or cancel the provisions of any other state or local law refllatin. co
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIOP
DATE OF APPLICATION 0 Z SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
dT --t.E t>
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
ecl ist 7�
Bu Ing
%f
echnician
co' ?rty
SPECIAL CONDITIONS:
included
overning this
he
es no . re I me
str ct'j
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building ( •}
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
¢.'R - 74-e
02* *61.00
*61.006
A *0.00
6'74.78
08-03-82
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
(1-03-82
67(85 *61.0,0(70 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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