1982, 10-26 Permit: 82B-202 ResidenceU
ArrLI LA 1 MN// I'EKMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
1 L05
LOT
.4
APPLICANT: COMPLETE
NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
BLOCK
��
SUBD VISION
3.
OWNER176°,1\1 A
ADDRESS Y^�,
CONTRACTOR• v <
' 4e
S �5T ^V�r-r0\l
HONE
4. ADDRESS
ZIP
o
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
9.
25NEW ElALT.
BLD. ❑ PLMB.
DESCRIBE WORK
PHONE
ZIP
PHONE
Valuation
ZIP
TO
O AD'N.
O MECH.
❑ RPL.
❑ M.H.
O MVE.
O POOL
0 OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
50o,4
Actual Set Backs in Feet
North 11(47y
'South I U East 'West�
Size of Parcel Zone Cl
a siVfication
7 I k:
}
�pp
C nst. Occu a cy Sprinklered
❑Yes ❑No ❑ Req'd.
4
-5-73`j Z
Main Floor
9Area o i pe ks
Q/�
Tic) (Li
No. Baths 'No. Stories
Building Area in Sq. Ft.
Upper Floors
Garage rea
Storage
Finished Basement
Unfin. Basement
No. of Dwellings
(5.1.1951\
VALUATION
kli
CERTIFICATE
of EXEMPTION
Location (Area)
Enum, Dist,
No. Rooms
Req'd.
Rec'd.
Not R d.
SOURCE
OF
UTILITIES
GAS/
EL CTRIC WATER SEWER Ownership
Public ❑ Private
i
JSE 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 n. •resume
to give authority to violate or cancel the provisions of any other state or local lawgulating consLruc '.n •r the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION /'D' /S" — gel SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
nv�alth
Planning
Fire Marshall
Utilities
Plans
SEPA Checklist ,
ing Techni n
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 $�
IPERMI I ":UMaER
02* *26400
*264006
A *000
967,82
10-15-82
2 6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE 1.16-b E D2 6-8 2
20.2. *26400
PERMIT NO.
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