1982, 07-06 Permit: 82A-5686 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
1. N. 4ty
LOT
1
2 OWNER
3 Mvcc
ADDRESS
N • 1440
CONTRACTOR
S,ct<rn6
ADDRESS
SAME.
BLOCK
4.
SUBOIVISIO
pR.cci>/
LEGAL DESCRIPTION - SEE ATTACHED
M 1 s5 tora •\.)
PHONE
PARCEL NUMBER/S
Oc ea 11552--
/ y
ZI P ;ett,s//yyo
Actual Set Backs in Feet S. North 'South
East (West SO
PHONE
Size of Parcel
'78 x r3S
Zone Classification
sZ Ok
ZIP
Type Const.
Occupancy
Sprinklereo
Dyes DNo D Req'd.
5.
DESIGNER
PHONE
Vet uatlon
`'�.Ot 6100
Building Area In Sq. Ft.
cfl4
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished
Basement
Unto). Basement
TYPE
7. OF
WORK
L(NEW 0 ALT.
0 BLO. D PLMB.
D AD N.
D MECH.
❑ RPL.
M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
1�1Z
No. St1ories
No. Rooms
5
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Notyq'd.
DESCRIBE WORK !/
8. SING.ti. W,tL,%� ,m�
GAS l ELECTRIC
VALUATION
tlo,ez:o
SOURCE
OF
UTILITIES
WAT
\�kxGO)
ER SEWER
tL
Enum. Dist.
Location (Area)
Ownership 16.1 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 consty9Eiep or the
performance of construction. SE .REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATIOr V A 2-- SIGNATURE OF APPLICANT%
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
En
444
Planning
Fire Marshall
Co. Engineer
jC D 7PceZa.,.(
-74g-
Utilitie
Plans Examiner
SEPA Checklist
Building Technician
r it
I
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ro
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[�jra9T2sALT gra. to J6Lb &EpJC1a &9
02:06 -r -ST ¢L..0 -r so Gm Aa.rzoat.( 6 '25R
A—ppa.os c.M t`bV•a 5'riL�tGTco l+.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
$
Mobile Home -JO•—
Other (Specify)
TOTAL $ 6C) gib
PERMIT NUMBER •(,
e7 -- -H
07* *5000
*'5'0006
A *0.00 8
56B52
'07.1.0'6'782
6419.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0
1
7'B167.112
DATE ISSUED
568:65' *15400
PERMIT NO
OJ
0. I-.
TOTAL
›-
0-
0 0-
0
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