1982, 02-09 Permit: 82A-920 Special InspectPLAN NUMBER
APPLICI !ON/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE, V417VS1-IINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3•COPIES
1.
JOB A RESf� {A' k 2O
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
BDIVISION
3.
owry Fzft, L,��jj, , /Ak
ADD E55 •
S2 -o 4 ( '70
5.
CONTRACTOR
ONE
c2.771P
6HONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
East
West
Size of Parcel Zone Classification
ADDRESS
DESIGNER
ZIP
Type Const.
Occupancy Sprinklered
Oyes DNo 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
O NEW
O BLD.
O ALT.
❑ PLMB.
O AD N.
O MECH.
O RPL.
O M.H.
O MVE.
O POOL
{LOTH ER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
B DES2 CRI
B%t�ORKv I v �` D�
VAL•UUAT IOONN 1/SOURCE }',V' GAS ELECTRIC
OF
9. UTILITIES
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership
Public ❑ Private 0
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 REVERSE SIDE FOR REQUIRED INSPECTIONS • '
DATE OF APPLICATION
9 - Q2
SIGNATURE OF APPLICANT Writ/
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single.'
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Spec: y)
(7101
rJn
TOTAL $ 2"
PERMIT NUMBER
02* *R00
*8.00
91.92
02-09-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
O'21f8'r 8'2t
920= *8.0011 -2 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL