1982, 01-27 Permit: 82A-669 Repair Fire DamagePLAN 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
JOB ADDRESS
I C9 I 0
1J -rod
LOT
BLOCK
SUBDIVISION
OWNER PHONE
3 Lk'," Q T n6L
ADDRESS IP
�- LK i0 GLI KkOKI
4.
CON RACTOR
Cj- I5I/(96 C2Iv
r
ADDI �ESS
N-- 4 1�ACOrrtAA
DESIGNER
2' (49
1
NE
0022
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S 27
Actual Set Backs in Feet1\11
North 'South East
9 d:2-
West
Size of Parcel
-o7
Typa Cpnst.
Occupancy
ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Valuation _ I 7
Zone Classificatio.n
Sprinklered
❑Yes ❑No ❑ Req'd.
Main Floor
Upper Floors
Building Area in Sq. Ft.
Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ N W D ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
i LO. ❑ PLMB. ❑ MECH. ❑ M.H. 0 POOL
'ff OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
8. �� I N � R r 76
VALU TION SOURCE AS ELECTRI
9 /-21 7 OF
CS/ / UTILITIES
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private
SE 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
//2-1/b
SIGNATURE OF APPLICANT.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIALONDITIONS:
I •
,K VAC: C ZZ3 Cf AS5 0C I jE 2 Kfr
• WHEN MACHINE VALIDATED IN THIS SPACE,
Rec'd.
Not R -.'d.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER �j
e'M --- °-9.
02* *2000
*20.00
*20.006
A *0,00
6682
0,1-27-82
2 6479,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
THIS BECOMES A PERMIT.
U' {:-a7 -8.2.
DATE ISSUED
PERMIT 44 9 z
* 2 O.
Fll F Cf1PY