1982, 09-16 Permit: 82A-8304 AdditionPLAN NUMBER r !�
r, r
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
c C1-5 P>
M(a1 ry
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
OWNER
3'�a.,L.a
PHONE
6124-aesz-
PARCEL NUMBER/5 t. .' 'J.{y2 OF'E,11i or LOTI
"ate, %42 arv02-R.t 1 rry
115443 – ►301
ADDRESS
. Cf3t8
MFat r4
ZIP
O'IPt-t c
Actual Set Backs in Feet
North South East WestS1 Coti
4.
CONTRACTOR
�mE
PHONE
Size of Parcel
-75Krip
Zone Classification
ADDRESS
Ceavie
ZIP
TypeConst.
SIJ
Occupancy
M4
5.
DESIGNER
PHONE
Valpatlon
ZI Ila
Sprinklered
❑Yes ❑No 0 Req'd.
3"Z
Building Area in Sq: Ft.
ADDRESS
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
,❑ NEW 0 ALT. (�J AD N.
IJ BLD. 0 PLMB. 0 MECH
0 RPL.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. iStories'
No. Rooms
No. of Dwellings
. CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not ece d.
DESCRIBE WORK
8. ADt' l rco.N
VALUATION
9.
6114tz-+yG.0 G.C,
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER
Enum. Dist.
Location (Area)
SEWER
Ownership J/
Public DPrivate LSS
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 construe ;jnp or
performance of construction. SEE REV RSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION - / • SIGNATURE OF APPLICANT/;
SPECIAL APPROVALS
71 � NAME DATE
Env
Plannin
Fire Marshall
Co. Engineer
. Utilities
Ing hniclan
PECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 4-•e°
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ (cc•
.V
PERMIT NUMBER
6aP.'g 3°4-
02r *47.00
*47.00'6
A *000 8
8303.2
-09=16.-82
•2 61179. •
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. '
0I19grille Y181'2'
DATE ISSUED - PERMIT NO. TOTAL
8.3042 *47:00ap.-
0
U
J
a“ -
-4;