1983, 09-28 Permit: 83A-9649 MHNIV IVVIVI6Gt[ APPLIGATILIN/PERMIT
SPOKANE COUNTY = BUIIANG CODES DEPARTMENT
` NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. E / I /,�°✓/EGc� 67-S C LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK BDI I O PARCEL NUMBER/S
2. 2 2- COAeii—L%M 6�5T•47-e5 r
OWNER „` PHONE �g6-$� r./r7f J
3. A, I
ADDRESS/.f ] ZIPP Actual Set Backs in Feet
/goo/
67 �7 U % " North J� � South 3East West f
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
LLtE/ NT
?Z2 –l0LO
S 0
AS /�i
4.
ADDRESS /
ZIP
Type Const.
Occupancy
Sprinklered
LL--(� /'s �-ss !I/��//
A4, � O `er
,
99
J?
❑Yes ❑No ❑ Req'd.
11
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
-55
/j
5.
ADDRESS
ZIP
Main Floof
Upper Floors
Garage Area
Storage
I
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Baseme
6.
--
—
—
No. Baths
No. Stories
No. R oms
No. of Dwel
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF El OTHER
�I
q BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.Not
RI
WORK
of EXEMPTION
I
v
DESCRIBE WORK
Enum. Dist.
Location (Area)
8 L .'41X40 1
FEES COLLECTED
VALUATI-ON
I SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership USE CODE
9. �
O F
UTILITIES
�
Public Private
❑
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 constructi�o%n. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
IA
DATE OF APPLICATION //j- d / SIGNATURE OF APPLICANT 4
Mech.
I
SPECIAL APPROVALS
NAME DATE
iv. Health
inning 10
re Marshall
>. Engine
ans
SPECIAL CONDITIONS:
o APvA Pew/ T /e�eN%env r ry/s
T1M45,. S7;gi11 DW 1D
,4-r T/r1� pF moi¢/� G�ONs N� nvA!
Aued4W-C- -
piamn PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
YCKMI 1 NVMt3tK
0 �* * 1 0::v0
*10000
9644_
6. 4 /
SEPA
>
C
C
C
Mobile Home
_
L
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09 28� 8` 9649'z *100.00a�.
DATE ISSUED PERMIT NO. TOTAL