1982, 07-29 Permit: 82A-6567 DampersPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3•COPIES
JOB ADDRESS
1. g
•
LOT
2.
15131 t, `ATALDn
SUBDIVISION
BLOCK
LEGAL DESCRIPTION — SEE ATTACHED
3.
4.
5.
OWNE
PAR
ADDRESS n
143 /1 \ TAA.DO
CONTRACTOR / 11
A4RES,4 GUtilr !
/d7,o I#1J1an4-
DESIGNER
PHONE
9l u- 7396
ZIP
R9a'L
PARCEL NUMBER/S
Actual Set Backs in Feet
North . 'South
East
IWest
TAC
P ONE
asr-aloo
Size of Parcel
Zone Classification
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage'
CHANGE OF USE FROM
6.
TO
'Area of Decks
Finished Basement
Unf in. Basement
7.
TYPE
OF
WORK
O NEW
❑ BLD.
O ALT.
❑ PLMB:
O AD N. 0 RPL.
O MECH. 0 M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. IA x711 F/uc
VALUATION SOURCE
OF
9. UTILITIES
GA6
Ox 1. ,n jtrn ce r W1I K/f.
SEWER
ELECTRIC
WATER
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE 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 cor:Struction. SEE REVERSE SIDE FOR REQUIRED INSPECTION_, /r ,
DATE OF APPLICATION
-a1-8.- 2 -
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Englnee
Utilities
Plans Examine
SEPA Check!'
B .,.0 :T��bnida
*Sae
SPECIAL CONDITIONS:
r.
Stftva
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Dmprr,
Plan Check
/OOS
9011 .
SEPA "
Mobile Horne
Other (Specify)
TOTAL
PERMIT NUMBER
Oa* *19.0.0
*19.006
A *000
65662 ,
07-29-82
z '6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
�
Oii7:x'(1',9=8121 6;567z *:T9.002.,�
DATE ISSUED PERMIT NO.
TOTAL