1983, 08-09 Permit: 83A-7507 Siding(PLAN 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
1.
JOB ADDRESS
n. 30 a &_
LOT
2.
BLOCK
SUBDIVISION
OWNER�
3. l! I U r`GL�t' �i ti LcL1rr�
A EkDRESS (�
. 30iFz'c4 A
PHONE
8hit
71v
LEGAL DESCRIPTION — SEE ATTACHED
PARCELNUMBER/S /75' ///)/f _
Z44J .2[)
Actual Set Backs in Feet
North (South
East
'West
CONTRACTOR
a. IM X/ & -M7 A/A( Ji
f . u:
ADDRESS
rl . 3/ c ale-A-xe - kt) a mac.
DESIGNER
5.
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes 0 N ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
O BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
Itq OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
DESCRIBE WORK
VALUATION SOURCE GAS
9.. 1 7& , a5 UTILITIES
OF
ELECTRIC
WATER
SEWER
Enum. Dist.
Location (Area)
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
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $,54
PERMIT UMBER
g9 - 7507
*5400
A *0.00 n
750.6
08-09-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
7 5,0.7 Z
*54000�-'
PERMIT NO. TOTAL
CII c rnov