1982, 08-26 Permit: 82A-7536 Renewal Permit #M5606PLAN 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. t I'ttS EVEeG
LEGAL DESCRIPTION — SEE ATTACHED
• LOT BLOCK SUBDIVISION
2. 2- t E14os..,( tv
OWNER
3. GEvh . ISO/nee oaopy l6Afrcj2 P.
ADDRESS
Cot_ c. Lvv Cgc pq " meL7ct
CONTRACTOR
4. ADDRESS
GA me
PHONE
838.2.511
PARCEL NUMBER'S
'26Dss447— i lC2
ZI P
aac54
PHONE
Actual Set Backs in Feet a1(c sr, N4
North 'South East
west
Size ofParcel
UL4 NIL V a
Zone Classification
St nX.c.0 E&jt& U -Y"
ZIP
DESIGNER
5. ADDRESS
PHONE
Type onst.
Occupancy
".3Jm-1
Vgivation Building Area in Sq. Ft.
414'3, 13ocs ..
Sprinklered
Oyes ONo ❑ Req'd.
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
B❑ EW 0 ALT. 0 AD N.
LD. ❑ PLMB. 0 MECH.
❑ RPL.
O M.H.
O MVE.
O POOL
grOTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not R.eq'd.
DESCRIBE WORK --�
8 COPA .E:E�lzjtPMtT 01:5GOG- R,e, OG t.cS
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
Enum. Dist.
Location (Area)
SEWER
SC-erIC
Ownership ,.,/
Public 0 Private el
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTIC .visions included
on reverse side, and know the 'same to be true and correct. All provisions of laws a d-• .Ina es go' rning this
type of work will be complied with whether specified herein or not. The grant . .er.• t does .t presume
to give authority to violate or ca- cel the .rovisions of any other state or oc:.ul.;. •cons .ction or, e
performance of construction. SE REVE SE SIDE FOR REQUIRED IN
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
SIGNATURE OF A• • ICA
SP CIAL CONDITIONS:
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu mg chnlman
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 6t' 09
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $54'ov
PERMIT NUMBER
02/1-75_
02* *5400
*54,006
A .*Q00 8
75352
08-26-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
7536'Z, *54,00'2
PERMIT NO. TOTAL