1982, 12-08 Permit: 82B-1723 Fire Damage RepairPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —'PRESS HARD TO MAKE 3 COPIES
STAT. ADDRESS
1. IIo
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2.
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SUBDIVISION
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MAILING ADDRESS
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4. AD_[(RE�S 2O ( CQ/ L1A `c. c&
DESIGNER i
PARCEL NO.
0742- — I70r
PHONE
PHONE
ZIP
LEGAL DESCRIPTION: pi: B r OI or
St/� 41 400 or S. 2-1-r or 11 Vz.
Actual Set Backs In Feet to: o-1'
I
q
JC1itj
North South ! East f West
5.
ADDRESS
LICENSE EXPIRES
PHONE
Size of Parcel
ZZprig..0 assificatioo
K -S
Spr'oklered
❑Yes 0No ['Reg rd.
PHONE 7
TypiVr0
Occupancy
�
Remodeled Valuation
New Const Valuation
Residential 111."-
Commercial
rJ/Commercial 0
Total Bldg. Hoar Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv Deck
Fin. Basement
Unfin Basement
TYPE 0/NEW f� ALT. ❑ AD' N. 0 RPL. 0 MVE.
7 WORK �' QLD. ❑ PLMB. 0 MECH. 0 M.H. 0 POOL OTHER
No. Battu
No. Floors
No. Fin. Rooms
No. Dwellings
CertifI. of Exempt.
or Variance
Required Yes❑ NoD
Received YesO No0
Number
DESCRIBE WORK
8. LiIION 2 M. .
VALUATION SOOUR E GAS
UTILITIES
9.
&b.°
EL CTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAG
SEPTIC
SEWER 0
Shorelines/Flood Hazard
Vaso Not Apollc.0
Ownershlp
Public 0 Private 0
I hereby certify that I have read and examined this appl cation 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 au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SI I E FOR REQUIRED INSPECTIONS
SIGNATURE Of I APPLICATION
OWNER OR AGENT AISt- - .e DATE /2'7--f
SPECIAL APPROVALS
PRELIM FINAL DATE
Env. Health
Planning
Are
Prevent.
Engineer
Utilities
,SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG Home
Other (Specify)
TOTAL $ Vl
PERMIT NUMBER-
oO-JE7- 1723
02* *6ao0
*68.006
A *000
172,22
12-08-82
B 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEIjS�
0 8'112!
PERMIT 4') ku *6 8 O OTOTAL