1982, 05-03 Permit: 82A-3437 AdditionPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY = BUfL7OIIIIG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
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PHONE /
ZIP
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4. ADDRESS �!
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S I'_' )(1—I
rj I _ O (+O
Actual Set Backs in Feet
North 'South ;2-2—
East Ir 'West
ZIP
Size of Parcel
8e, i3r
Type Const.
N.iI v
Zo Issification
Ogpency
Sprinklered
❑Yes •❑No 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area -of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑/New 0 ALT. 0 AD N. 0 RPL. 0 MVE.
ID' BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. Of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
NO7eq'd.
DESCRIBE
WORK.
R ' 8. A9tji ^- l
Enum. Dist.'
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private
/OSE CODE
I hereby certify that 1 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
n
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
J// r ti
ire Marshall
Co. Eng
Utilities
n ee
P
ans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT
SPECIAL C9IRNDITIONS:
\JO `t 3 -3 (him Ifs
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
' Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
PERMJT NUM 'ER
g�%A. M— 3 %
02* • *89.00
*89.,00
*89.006
A 'tr 010 0 8
343.62
05 .03L'82
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
re51ythip !TitI2
3141331 *89.00a�
DATE ISSUED PERMIT NO. TOTAL
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