1982, 01-18 Permit: 82A-366 DamperPLAN 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. E. /3 O
LOT
2.
BLOCK
1
11
13D V �y't al-/ Y,CI V c-
SU I I ION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWNER
3, J4 al S
ADDRESS
E, /3003
CONTRACTOR
/i
el /I a.<44
4.
B4_ xi?
64 flair Dar. -r
PHONE
ZIP
Actual Set Backs in Feet
North 'South
East
'West
ADDRESS
t /d 7/0
/7 h/%F 1 f/rc
1 -
PHONE
7?fr-A, 0
Size of Parcel
Zone Classification
ZIP
9'9.2 /
Type Const.
Occdpancy
5p ri nkl ered
❑Yes DNo 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
O BLD.
❑ ALT.
❑ PLMB.
❑ AD N. 0 RPL. 0 MVE.
❑ MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. /-5 tali
6' Petal re
La -
Gas Ft <4-4 e p
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
AS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
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 APPLICATION /- /3 — Y SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marsha
Co. Engineer
Utlldies
Plans Examiner
SEPA Checklist
Te CI
SPECIAL CONDITIONS:
F C/.O
S,caa.,v
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech. AOC oo
Sy; ed
Plan eck
SEPA
Mobile Home
Other (Specify)
TOTAL $ dyad
PE ly IT UMB
6�
04* *14.00
* 1.400 1-6
* 14006
A *Q00
3652
b1-18-82
6479.
a.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i. 'i n p it.
O;li!'(iaii121 36.62 •1•4.0'0a�,_
DATE ISSUED PERMIT NO. TOTAL