1982, 06-07 Permit: 82A-4584 MHPLAN NUMBER - APPLICATION/ PERMIT
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SPOKANE COUNTY —> BUILOING CODES DEPARTMENT
�} • NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
�• -29i0 /V -TOEL LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
OWNER
3. % )C
ADDRESS
�29iD N. oE�
CONTRACTOR
4. C0,4GN-Lr7'E
ADDRESS
lc-' 124e 1
DESIGNER
5• ADDRESS
CHANGE OF USE FROM ITO
6.
PHONE
ZIP
Actual Set Backs in Feet
h/� �7
CJ4 /
,�`
North rs21 South /V, ` East 62- ' West -?0 A
PHONE
Size of Parcel i
Zone Classification
`28- /7/
E37X 120'
# 9 /'c
ZIP
Type Const.
Occupancy
Sprinklered
X216
:N_
I
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
Req'd.
Rec'd.
Nqt geq'd
ZIP
Main Floor
Upper Floors
Garage Area
Storage
of EXEMPTION
[Ownership
X
DESCRIBE WORK
Area of Decks
Finished Basement Unfi Basement
TYPE
NEW
❑ ALT.
❑ AD'N.
❑ RPL.
❑ MVE.
o. Baths
No. Stories
No. Rooms
No. of Dwelling
%, OF
WORK ❑ BLD.
❑ PLMB.
❑ MECH.
XM,H.
1:1 POOL
1:1 OTHER
_
CERTIFICATE
Req'd.
Rec'd.
Nqt geq'd
of EXEMPTION
[Ownership
X
DESCRIBE WORK
num. Dist. Location (Area) FEES COLLECTED
8. �c E
1%6z S
ES/
E t
�2
i ,!
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
USE CODE
9. % UTILITIES I I I -<507- Public ❑ Private ❑ I I Single $
1 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 Building
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 Plumbing
A�
DATE OF APPLICATIONL-- SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
'Nb't2�
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
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Plan Check
PERMIT NU11 0--R
07* *100.00
* 1 00,00 U~i
* 1 00,00
A *0.00 CS
4583
06-07-82
.17 1479,
SEPA
CL
Mobile Homet 19�2'��
O
U
LU
L4-
Other (Specify)
TOTAL $ tOO.EX�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
4
Id i g Te nician PERMIT IS NONTRANSFERABLE o O J. -
I�j� 0�6.��-82 458.42 *1DO.00aI-
��-- PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE IS3UFn PFRAAIT Kin TnTo i