1982, 06-08 Permit: 82A-4690 MHPLAN 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
JOB ADDRESS
f. V
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2. \O
OWNER
3. �qCt 1
ADDRESS
N . V'3IFl
CONTRACTOR
S�awuo
ADDRESS
DESIGNER
BLOCK
4.
5.
SUBDIVISION
IM S.bN U ♦c.,"
PARCEL NUMBER'S
ssco . •-loaasc
Ci a --•-n•4
.PHONE
CC}Z –QS'1'A
2 -
ZIP
Glut eat `
Actual Sat Backs in Feet
North Sr 'South t8`
East —1.2 Wes[
PHONE
Size of Parcel
62.414 -se teS5,ctiMCA
Zone Classification
ZIP
Type Const.
Occupancy
� =3
Sprinklered
❑Yes ONo 0 Req'd.
PHONE
ADDRESS
ZIP
Valuation
Main Floor
et4
Building Area in Sq. Ft.
Qty
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE
7. OF
WORK
I1NEW 0 ALT. 0 AD N. 0 RPL.
0 BLO. 0 PLMB. 0 MECH. lel M.H.
0 MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Byoms
No. of Dwellings
CERTIFICATE
of EXEMPTION
R eq'd.
Rec'd.
Vot Reg7tl.
DESCRIBE WORK
8. StNC.I,G 4J.Ac
YNO re tL.0
1 'VALUATION
J.' �rt'i�
SOURCE
OF
UTILITIES
GAS
tit rn C t4C'Cca)
SEWER
Certse
ELECTRIC
WATER
Enum. Dist.
Location (Area)
Ownership USE CODE
Public 0 Private
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 f./1 / (J SIGNATURE OF APPLICANT
SPECIAL APPROVAL SPECIAL CONDITIONS:
NAME DATE
Eny. Health
Plann nq p
Krei i, 6.�U15z
Fire Marshall
Co. En 'neer
D. free --r (2191s-1
Utiliti
Plans Examiner
SEPA Checklist
Ding chnic'an
o-'
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home5 c'- at"
Other (Specify)
TOTAL $ 60.0ED
PERMIT NUMBER
s;aA -4-6
0
07*
A
4609
*500:0
*50.00 66
'*50.0;06
*000 8
•
10'6,‘-08-8.2
2 0479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1
.,aI JFA
DATE ISSUED
469.05 *50,0'0a°-2
PERMIT NO
TOTAL
0
0
U
LLI
- J
L
h
A/Woo' ea'' ) 165.91
AA:_.: /S-12
SEER:
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ADDRESS: S: N
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