1982, 05-21 Permit: 82A-4018 ACPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COlviPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS r
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
PARCEL NUMBER/S
OWWNER
3 XL -0L//9/✓
ADDRESS /
//' b6- C//7M/9A1
CONTRACTOR _
4. ,�L,if�l1�/t /`'"L/4-4; Z./ t,*
PHONE
921 -9 -
ZIP
9f2n4
PHONE
5 %//
Actual Set Backs in Feet
North (South
Size of Parcel
East 'West
Zone Classification
ZIP
Type Const.
Occupancy
DESIGNER
5. ADDRESS
PHONE
Valuation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin, Basement
TYPE
7. OF
WO RK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
AD'N. ❑ RPL.
MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
8. /7Lz. 9ort%/X C`/A/,3 /l2eidt/'2 ��,Ni✓�%t' /16/4—'4
Enum. Dist.
ILocation (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS 1 ELECTRIC
WATER
SEWER
Ownersh ip
Public El Private ❑
USE CODE
1 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 (hority 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 5-/%-9.2--
SPECIAL APPROVALS
NAME DATE
Env. I -lea Ith
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$/ 'A
PERMIT NUMBERS I
S I
04* *140(,
* 1400
* 14.006
A *0.00
401.78
05-21-82
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0`5-12'x,
DATE ISSUED
401.82 •*14002
PERMIT NO.
a.
TOTAL