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