1983, 09-16 Permit: 83A-9134 SpaPLAN NUMBER
APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY -BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
L/ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1 Jd-'DS Ll 9 /le ✓ LEGAL DESCRIPTION — SEE ATTACHED
OW R
3.
DRESS
_2
NT RACTO.Ri
4. ADDRESS"
�C(,:::,Y
DESIGNER
5. ADDRESS
U
E
-vim
ZIP
PHONE
12Y _-15' Fe
V92-0 6
PHONE
ZIP
CHANGE OF USE FROM TO
6.
TYPE ElNEW I -]ALT. 1:1AD'N. -1 RPL. El MVE.
7 OF EJ OTHER
WORK ElBLD. 11PLMB. ❑ MECH. ❑ M.H. POOL
ES BRIBE
8 .
Actual Set Backs in Feet
forth South
East West
iize of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
✓aluation
Building Area in Sq. Ft.
Main Floor I
Upper Floors
Garage Area
I Storage
Area of Decks
Finished Basement
Unfin. Baseme
No. Baths
No. Stories
No. Rooms
No. of Owel
CERTIFICATE
Req'd.
Recd.
Not R
of EXEMPTION
I
Enum. Dist.
Location (Area)
FEES COLLECTED
AL T N SOURCE GAS ELECTRICI WATER I SEWER
Ownership USE CODE
OF Public ❑ Private ❑
9. UTILITIES Single $
1 hereby certify that I have Ad 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 loca) law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTI QNS Plumbing
DATE OF APPLICATION �'- L° SIGNATIIRF OF APPI ICANt��l�^ Mech.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
Plan Check
SEPA
!Or /j�j/��-. Mobile Home
Other (Specify)
TOTAL
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
.4* *1°00
* 1 9.0®6,
AJ
9i3.3<
0 16-R3
6479.
PERMIT IS NONTRANSFERABLE 0 9 1 6'- g` Y 9 113.4 z * 19' 0 0 ° _
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL