1982, 05-21 Permit: 82A-4037 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
1.
2.
3.
JOB ADDRESS8 c
IS
LOT ! BLOCKSUBDIVION
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OWNER
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ADDRESS
CVC
CON�ACTQR�
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ADDRESS
ds
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S f.-7 — 0606
ZIP
DESIGNER
5' ADDRESS
PHONE
ZIP
Actual Set Backs in Feetm
Northa!South East (West 20
Siz of Parcel Zone Classlfic tion
12Jf x ?8 � I r k�iv-7167 l
Type Cpnst. ccu panty Sprinklered
V N-3 ❑Ves DNo 0 Req'd.
Valuation Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in.. Basement
7.
TYPE
OF
WORK
LTJ NEW 0 ALT.
0 BLD. 0 PLMB.
ID AD N. 0 RPL. 0 MVE.
ID MECH. M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Rebid.
Re 'd.
Not S'eq'd.
DESCRIBE O1 I-0 � V C!'f >c 70
B. VAA �L /ATI_O"^sN SOURCE GAS ELECTRIC
9. 1(� WvOF
UTILITIES
Enum. Dist. 'Location (Area)
WATER
SEWER
Ownership �//
Public D Private 'd
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�RSIDE FOR REQUIRED INSPECTIONS ,�1
DATE OF APPLICATION 510 /l5 SIGNATURE OF APPLICANT a' 'u't"t /�
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env.• u /
ria
Planning
Fire Marshall
Co. ngAerar
er 5•A
Utilities
Plans Examiner
SEPA Checklist
Bu
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMirNVVJMBER
g2 -.ick -403-7
07* *5000
*50.00 tri
*50006
A *0.00 8
399:92
O'5L21 _52
647'
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11(�1)jl
DATE ISSUED
40.41 Z
PERMIT NO.
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5 0.'0'01.0. -
TOTAL
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TOTAL ' ti
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