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1982, 10-18 Permit: 82B-0357 ResidencePLAN NUMBER a7 APPLICAT5ON /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 1. iiO4- i3U.iz,Ns LEGAL DESCRIPTION — SEE ATTACHED LOT 2.'5 OWNER 3 Mu11RM ADDRESS . 1 D24 CONTRACTOR 5K►,mE ADDRESS DESIGNER BLOCK i 4. SUBDIVISION P.N1 iS t Apr) : r orc PHONE C,ot :QcAG LO&) PARCEL NUMBER/S -4q 05 - 5' ADDRESS ZIP ccCtz o - Actual Set Backs in Feet North !South 20 !East .50 !West PHONE Size of Parcel Bo x' iii tacPAYAILY Zone Classification ZIP Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. PHONE aluation 3i 'off Building Area in Sq. Ft. ZIP Main Floor S18 Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK LeNEW I1BLD. ❑ ALT. ❑ PLMB. ❑ AD'N. O MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL 0 OTHER No. Baths No.1 Stories No. Booms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK 8 I NCaCE VALUATION SOURCE OF 9. UTILITIES GAS Enum. Dist. I Location (Area) ELECTRIC WATER SEWER Ownership Public 0 Private 1/f 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 REV SE SIDE FOR REQUIRED INSPECTION DATE OF.IPPLICATION SIGNATURE OF APPLICANT �' Y ,eel, SPECIAL APPROVALS NAME DATE Envijeap Planning Fire Marshall Co. Engineer /9 6". �D.11,0 Utilities Plan miner / // SEPA Checklist Building Technician SPECIAL CONDITIONS: • PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $'2,28.(3x5 PERMIT NUMBER e S Y A * E 52 1 _` (7-E'2 64lc WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 11 L',2 '9. -8 2 DATE ISSUED 35.72 *228.��&L� PERMIT NO. e 1 7 / _ / a6 1