1982, 07-15 Permit: 82A-6049 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
.14 CI G1zrac›W
LEGAL DESCRIPTION — SEE ATTACHED
2.
LOT
CQ
BLOCK
SUBDIVISION
M\sstow Vts-rn
OWNER
3 iwME9
ADDRESS
N • .3e ctri
CONTRACTOR
4.
5.
gr
Sk6
PHONE
Y& Co23i w�
FPts2
ZIP
QQ xoC
PARCEL NUMBER/S
litottattagf r"']552— 0 O
Actual Set Backs in Feet
North 7.61 (South
East -3C-' (west
PHONE
Size of Parcel
-114.4.x 166.0.1
Zone Classification
ADDRESS
Sinvvt6
DESIGNER ,
ZIP
Type Const.
f`.1
Occupancy
Spnnklered
❑Ves ❑No 0 Req'd.
PHONE
Valu tion
T3, ebo
Building Area In Sq. Ft.
el a 4-
ADDRESS
ZIP
Main Floor
G'x¢
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Until). Basement
TYPE INEW ❑ ALT.
7. OF
WORK 0 BLD. 0 PLMB.
❑ AD'N.
❑ MECH.
❑(BPL. ❑ MVE.
CJ M.H. 0 POOL
•
0 OTHER
No. Baths
No. Stories
No. Rooms
5
No. of Dwellings
1
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. �l�ac.t6
VALUATION
W cV3c N'€0Z. (keric.
Enum. Dist.
Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
t M LL
Ownership
Public 0 Private cle
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 APPLICATIO
L/7 C?
SPECIAL APPROVALS
NAME DATE
v. ealth
bv5726.
Planning
Fire Marshall
«o. Engipger
U'ies Q
n/I s/s7_
Plans Examiner
SEPA Checklist
B ng Technician
SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
rCO rnn�Q GQQ to1vs.Q. ?re) F2 ( C1/4113,., (�
\1\V"PA! C4V\� ctk 1 S4tN rD'8n-tuPUb \
0-Q OccQ, :o� ct.` 4 , is Ct1AS$1r0.0 .611 or
634-rAvmxt (ser,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne 'ce0
Other (Specify)
TOTAL
$
PERMIT NUPBitR_
— C004 -c)"
07* *50.00
*50.00
395.1A
0.5:=1".9:-82
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
6,0 4 9 5 *;'5 0, 0 0 fi!
PERMIT NO. 'TOTAL
Ana' a r'fl"% 9Yy'
a•
rsi'
to•
E
iy
u•.
1?.v-
2 0 .
'
Gif'i9v y Arc/
•
'-1 vi hJ ti d H -. H �
A til 1'J ,-3 'd (+l U .. LI II b3 1-1
Pi Pi LI Pi Pi
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