1982, 10-15 Permit: 82A-9656 DamperPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY_ - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,'WASHINGTON 99260 / (509) 456-3675
2.
3
4.
5.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3•COPIES
btaldti
SUBDIVYSION
OWNER
A D D REyS
11
CO NnTR�l/f�
nnAC •' �\)
J l
A RFSS ^/
DESIGNEf�� 1 i
PHONE
PIN
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
Actual Set Backs in Feet
North !South [East 'West
Size of Parcel Zone Classification
Type Const.
Occupancy
Sprinklered
Oyes ❑No 0 Req'd.
Valuation I 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
Unf In. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
8.
IBE WOR Ye -7
❑ ALT. ❑/ AD'N. 0 RPL. 0 MVE.
0 PLMB. I MECH. 0 M.H. 0 POOL
LUATION SOURCE
OF
UTILITIES
GAS
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 INSPECTION!
5"
LECTRIC
WATER
0 OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enurn. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
Req'd.
DATE OF APPLICATION ' b✓ ia -Z
SIGNATURE OF APPLICANT z\ `)/! ""''�I+ci
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ing
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
3.24 96s6.
04*, *1400
*14,006
A *GOO o
9655q
10=15-82
2 6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
l,• 965:6Z *1.4.;0 g,
11'0 .Jl'.;5' P,B,Z'
DATE ISSUED PERMIT NO. TOTAL
0
0
0
U
LsJ
J
LL