1983, 04-08 Permit: 83A-2728 MHR _ APPLICATION/PERMIT
SPOKANE COUNTY = BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SP&KANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
Occupancy
Sprinklered
LEGAL DESCRIPTION - SEE ATTACHED
1. /X7W E. a ,
.�
LOTB
2. 6
KISUBDIVISION
2
-��Zr s
VaIuat n
`4
PARCEL NUMBER/S e8ss72— —/sw,6
OWjVER
PHONE
3. ,LL4
,E.TF,�S
'
ZIP
ADDRESS
, / ' `�� v�
ZIP
2 7
Actual SetBacks in Feet
North d South East ® West 22
CONTRACTOR
/��
/�% C '�
PHONE
S.3S--/7 ,3
Size of Parcel Zone Classification
A91 l i
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
4, b&—
.�
Dyes ❑No ElReq'd.
DESIGNER
PHONE
VaIuat n
`4
Building Area in Seq.. Ft.
13
5. ADDRESS
ZIP
Main rloor
Upper Floors
Garage Area
Storage
d
CHANGE OF USE FROM
TO
Area of Decks
Finished
Basement
Unfin. Basement
6.
—
No. Baths
No. Stories
No. Rooms
No. of Dwellir
TYPE IiCI NEW ❑ ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
II
7, OF , / ❑ OTHER
❑ BLD' ❑ PLMB. ❑ MECH. LIQ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8.iC��..
VALUATION SOURCE 'ASIC WATER SEWER Ownership USE CODE
OF Public QPrivate VI4
9, UTILITIES I I
Single $
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
Building
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 -
Plumbing
IaZDATE OF APPLICATIORC 3n. --113 SIGNATURE OF APPLICANT055�
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
7v. Health
I Nn .4rreo �e.
cll vt> ��� #r Tl1i�
anning
re Marshall,J
Ie
D. Engineer
tilities
ans Examiner
PERMIT IS NONTRANSFERABLE
I)PORMT FxPIRFc nNF VFAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Hom 100. 0
Other (Specify)
TOTAL $
U PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
-z f �i ' 00 Y
G
0a -05-?3
__ 6 479
E,
0;41-4,98 r-8`3' 2F7,28 z *'10 0.&0 f
DATE ISSUED PERMIT NO. TOTAL