1982, 07-30 Permit: 82A-6588 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. JA.D J 0
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LOT B CK SUEtISION
2..' 9.
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OWNER
3.
4. ADDRES°
DESIGNER
LEGAL DESCRIPTION = SEE ATTACHED
PARCEL NUMBER'S r•
-
ADDRES$ 3'+ » c V ✓ - . LCL/I�6etr /J
5� Fn / vS }`� VlitT��TV.V
CON
iter
HONE
ONE
Actual Set Backs in Feet
North (.0 'South
Size of Parcel
.x
7b
5.
ZIP
Type Const.
IT ecu ancy
East (West
Sprinklered
❑Yes ONo 0 Req'd.
Zona CW 1s,fi cation
PHONE
Valuation Building Area i Sq. Ft.
ao?,a¢o-e
ADDRESS
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK•
TO
NEW 0 ALT. 0 AD N. 0,R�PL.
0 BLD. 0 PLMB. 0 MECH. LJ M.H.
Area of Decks
Finished Basement
Uofin. Basement
0 MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Nott
8.
DESCRIBE WORK
MLX 1 ii 4 > z�S K moi- G
VAL ATIO SOURCE GA ELECTRIC
g. Z OF
�j 11W"" UTILITIES
Enum. Dist.
Location (Area)
WATER
G✓-�SSEEWW E R
Ownership
Public 0 Private
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 f%
DATE OF APPLICATION : SIGNATURE OF APPLICA7 - .�
SP CIAL APPROVALS
/ ] NAME DATE
EnvJHe
Planning
!/Ibj �/eZ
Fire Marshall
`Co. E cneer
7.a -ay 7/240)0
Utilities
Plans Examiner
SEPA Checklist
Building to clan ^
SPECIAL CONDITIONS:
eot- .r.Of•tom` to efl.-5 PL... ,ioi,cz .</ o uczNsr2.-
Lo Com,. 9.-r-c...GT Aar (LO," -G(4 LJ N N CLA.Cte
Ma A- e•JC-,C fgc—Catjae
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
boa
�
PERMIT NUiJIBE{7-
5/02R 6588
07'sr *10000
*100.006
•A *000
.641.52
.07=2682
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0110S Z
DATEilSSUED PERMIT O.
*:10 O AO, L� -
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