HomeMy WebLinkAbout1982, 06-16 Permit: 82A-5055 MHPLAN 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
1.
JOB ADDRESS
.
3
Lj.OT
�2S WN
BLOCK
CA1tJiN4HANI
SUBDIVISION
4"3",01.: iPJ tJ kt i
LEGAL DESCRIPTION - SEE ATTACHED
ER
ML -46 >- L,%, J `'2
ADDRESS
'x I�
PHONE
ZIP
4.
CONTCT,O
PHONE
ADDRESS
ZIP
PARCEL NUMBER/S
N. r --)C7 or r4. ll{ �-' va7 q
r % 4-I or- Wr [ii I 44 Lot
Actual et Backs in Feet
North South (EastIS' 'West
Size of ParcelI ( ne C ss catiiL
JIfeZ
130
DESIGNER
5. ADDRESS
PHONE
Type♦Cast. Kupancy
V ation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
'344
ZIP
Main Floor
144
Upper Floors Garage Area
Stage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW ❑ ALT. ❑ AD N. ❑ R L. 0 MVE.
0 OTHER
0 BLD. 0 PLMB. 0 MECH. M.H. ❑ POOL
No. Baths
1 1k2-
No. 1Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Noq'd.
DE`r'S�RIBE WORK
FEA\i1b (24x56)
8. 0111
SOURCE
9 �/ �i(f50m, s V UTILITIES
OF
GAS
ELECTRIC
Enum. Dist. I Location (Area)
WATER
SEWER
Ownership
Public 0 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 author ' _y 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 INSPECTIONSS
DATE OF APPLICATIORft (ZSIGNATURE OF APPLICAN "�ON}% a
SPECIAL APPROVALS
NAME DATE
Ith
P\n nin
Fire Marshall
07
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildin• ec ..' Ian
SPECIAL CONDITIONS:
OPF19' of r /low
)1vtaal--rs
/ fir e ie
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
e
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
I ad
Mobile Home
Other (Specify)
TOTAL $ I.0
PERMIT NUM,
.g52.4.4
07* *100.00
*100,006
A *000 S
505.42
06.16-82
z 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0,0116'— 8 2 5'05.55' *.10 0.0 0 24,
DATE ISSUED PERMIT NO. TOTAL
C d R/v4 A Air 4e
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15
27
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