1982, 11-05 Permit: 82B-691 ResidenceIPLAN NUMBER
I
APPLICATION/PERMIT
SPOKANE COUNTY — BUILbING*CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 -COPIES
JOB ADDRESS
t.
LOT
2. z
OWNER
3. (M Asco
ADDRESS
W . oto
CONTRACTOR
4- SIRS�
ADDRESS
w)(5
DESIGNER
6. ADDRESS
BLOCK
1
S . 3$ l5 Fox C.`T
LEGAL DESCRIPTION -.SEE ATTACHED
SUBDIVISION
M'V Lo MC
\S:
LA
PHONE
4a54--eagen
PARCEL NUMBER/S
3'5s41.- O°t0Z
C RAArgaVL1=w
ZIP
ckc ac 4 -
Actual Set Backs in Feet
North South33
East 15+ IWest
PHONE
Size of Parcel
—We X t fKPP2aw
Zone Classification
SLNG.LE ViVint
ZIP
TTyypp'e.�Const.
i4•3
Occupancy
.12
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valfwation
43
Building Area in Sq. Ft.
ZIP
Main Floor
tZ3Z44
Upper Floors Garage Area
Ghee free
1S0 6MN
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
W(/NEW 0 ALT. 0 AD N. ❑ RPL.
VJ BLD. 0 PLMB. 0 MECH. 0 M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Rpn d.
DESCRIBE WORK.,y��
8. eIU LLE +WMtl�f—2.c.stt-r cE
Enum. Dist.
Location (Area)
VALUATION I SOURCE
9. 'UTILLIITIES
GAS
ELECTRIC
WATER
SEVER
Ownership /
Public 0 Private I
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
47—
DATE
TDATE OF APPLICATION /2(9(% / + --SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
x Nen. CZE3219
( , Planning
X
v
Fire Marshall
ngi
e
SPECIAL CONDITIONS:
/ r,4n/1C iu /04
Plans Examiner
Mot Zf-Ca
SEPA Checklist
Building Technician
001-9-
'Bps..c ROW
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building °Z` I -°°
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $744.R7
Aa
PERMIT NUMBER I
02* r1 69.006
A *G00 0
' 69.02
1.1-05-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.11k: B5 82
DATE ISSUED PERMIT NO.• TOTAL
69.1g269.00(10
a
(Pc. 9 ) �\
(z T9)
1286 Dim
t2 -
rU ( :70)
:304.)
)
Id_L
°I)PL-33
5, 399 rd% GoLic[
•
i ce_ 16 -7"
NIii:2I:LoMC, 1 ar
12.8 G re_11
�1-1 r' -i'I.A
VA.K, SWAGE
5 k{.AkE. Roof-
Fi►Pc-c___.