1982, 06-16 Permit: 82A-5053 SidingPLAN 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
JOB ADDRESS
1.1
y1 3 K
LOT.? I BLOCIliBD VIS�N
2. I
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S o/ 3 5•10
OWN R
3. (-Jeri( L r Sfan p.e r
ADDRESS
N . 3Ycfl FA rt
CONTRACTOR
a. A fir' vru
Sr-MAOifs('o nira do I's
ADDRESS
til ; 310(0 Arern n P 2 nCiri
DESIGNER
5.
PHONE
gal -1 -x-113
PHONE
q
Actual Set Backs in Feet
North 'South [East 'West
Size of Parcel 1 Zone Classification
P
Type Const.
Occupancy
Sprinklered
Oyes ONo 0 Req'd.
PHONE
Valuation )Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE O.NEW
7. OF %BLD.
%BLD.
DESCRIBE WORK
•
• ALT.
❑ PLMB.
O AD'N.
O MECH.
O RPL.
O M.H.
O MVE.
O POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Req'd.
VALUATION
a. 3180
SOURCE II GAS
OF
UTILITIES
ELECTRIC
WATER
SEWER
Ownership
Public 0 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 a�! /'*/11 SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engineer
Utilitie
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABI
PERMIT EXPIRES ONE YEAR FROM DATE 0 SUANCE DATE ISSUED
Recd.
Not Req'd.
FEES COLLECTED
/l
Single $ -r-r
Building
Plumbing -
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ —
PERMIT NUMBER
&�A - Go53
02* *54,00
*54.006
A *000
505.2
'06.16=82
6479.c
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
016i%.2'6`.giB''2 5'015:34 •5,400 FP
PERMIT NO. TOTAL