1982, 06-22 Permit: 82A-5195Addition(PLAN NUMBER I APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 8" JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK ISUBDIVISIONPARCEL NUMBER/S , -6XW C* 012 '&(L t¢3
2.
OWNER
3. '��`{
ADDRESS
N. 0's Tr F
CONTRACTOR
4 'c', 6. CoN
PHONE
�i7-� a��'cd 11543 —icmr� L
ZIP �r Actual Set Backs in Feet
RA2.4sc North South IEast West
PHONE Size of Parcel Zone Classification
ts%4 j A6..S4--.t)LA
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
P -O• -Z43l
'34 -:LQ?
tj I
la —In.
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation a
Building Area in Sq. Ft.
G, 24n
5.
ADDRESS
ZIP
Main Floor
Jim
Upper Floors
It52-c>
Garage Area
Storage
—
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
TYPE
dAD'N.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
10/r EW ❑ ALT. ❑ RPL. ❑ MVE.
`
Z
7, OF ❑ OTHER
-1
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑POOL
CERTIFICATE
I
Req'd.
Recd.
Not Req'd
I
of EXEMPTION
✓
DESCRIBE WORK
Enum. Dist. Location (Area)
8• —to
FEES COLLECTED
p4plo i Tt o
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership USE CODE
9.
OF
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
x'75,00
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 SIDE FOR REQUIRED INSPECTIONS
Plumbing
`REVERSE
DATE OF APPLICATIOd/r. 1 ^ I�
dyW SIGNATURE OF APPLICAN
Mech.
r
SPECIAL APPROVALSI SPECIAL CONDITIONS:
NAME DATE
Pla-nning
Fire Marshall
Co. Engineer
Utilities
Plans Wminer
5PEPN CheYklist
Bui1ding1-echni
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
'75 -
PERMIT NUMBER
02,4 5125 1
r
62* *7500
51 9,4
6-22-= 2
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
O:i61�2 8° 2
5 19) Z
DATE ISSUED PERMIT NO.
*75.00a� _
TOTAL
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