1982, 06-24 Permit: 82A-5368 Fire Damage RepairPLAN 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.
OT
2.
L
3 ADDR
JOB ADDRESS
lop hOr,✓K
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK
Rg
ESS
CO RACTOR
SUBOI V ISION
C-)0 ,6\0C)111C1K1
4. A DS
M)R 20 '
DESIGNER
5. ADDRESS
q2or-735
PARCEL NUMBER/S 2 02) I - /lq j
Actual Set Backs in Feet 2 I11\i�
North South ( East
PHONE Size of Parcel
'West
Zopelassification
t-/Vc
"72-09
PHONE
Type,Const.
Valuation
O,Ccupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ 7W lE ALT. 0 AD N. 0 RPL. 0 RI3LD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
NotR7'd.
DE CRIBS WOR8.f �(�VA UPFTIO9. 000
SOURC- I GAS
OF
UTILITIES
ELECTRIC
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ 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
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Builds ch
CI
SPECIAL CONDITIONS:
�� UIQ. C z2$- k1mz-m15 37 PO)
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$I0)
PERMIT NUMBER
-
02* .108.00
* 1 08,006
A *000
5367:.
06-24-82
6479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0,br 24-;82 536.85 *108,0_0a -