1982, 12-14 Permit: 82B-1904 InsulationPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENTfOF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOK7iNE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES -
PRESS HARD TO MAKE 3 COPIES
STREETADDRESS
1. - I00;
LOT
2. 7
BLOCK
2-
3 DJm5r'N
M1 t1 -ADDRESS
N 1007
4. ADDRESS
CON 6CTpfj,
SUBDIVISION t JF5 , ypr pII �I-�jy'5-s
fb���j�7�/�YAchic-0;22"E "2 E /SO3
rvi -11L117--
PHONE
LICENSE EXPIRES
PARCEL NO. I75+; - 132_'
LEGAL DESCRIPTION:
Actual Set Backs In Feet to
North ISouth
IFaest
Size of Parcel
st�� W
Zoise_0Classif 'cation
Residential V
Commercial 0
ZIP
TypeV IV
Occupancy
S3
Spr nklered
❑Yes DNo Reg 'd.
DESIGNER
5.
ADDRESS
PHONE
New Const Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin Basement
TYPE 0 NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF
WORKD. ❑ PLMB. O MECH. 0 M.H. 0 POOL
fd OTHER
No. Batt
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes El Non
Received Yes No❑
Number
8. D�SC�BE W i IV L cq 1 rtsI % 51\F-22
VALUATION SOURCE GAS ELECTRIC
9- I-zCOUTILLIITIES
Shorelines/Flood Hazard
YesO Not Apolic.0
Plans Required n
Received 0
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC ❑
SEWER 0
Own
Public nership Private C7
I hereby certify that 1 have read and examined this appl cation 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 au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REO IR . INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPR a ALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plat
Exam.
Building
Tech.
r24
APPLICATIO /c,
DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ --L--
PERMIT NUMBER
02* •24,00
19032
12-14-82
2 6479,
-',
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE
PERMITLC2. 0; 4 Z * 2 Y 0.0 ro}AL