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1982, 07-27 Permit: 82A-6442 MHPLAN NUMBER " . APPLICATION/PERMIT SPOKANE COUNTY —' BUitDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 -COPIES JOB A RESS ,2. ff 1. 1 0 i „1,1120:�=�.� !coo l/M1- ADDrjE'✓SS`_ �(/, �/// 1 [Cy/J, 1'" - /I'' 1 1�11� PJ CO NTGVRfa CTO� li ADDRESS 3. 4. LEGAL DESCRIPTION - SEE ATTACHED 9902 PHONE ZIP PARCEL NUMBER/S 06.%� - 015 Actual �Set liBacks in Feet North i2/ 'South East I! 'West Size of Parcel �LI TyQrt Cgnst. Zone CI ssl icatlon ccuuncy 1 'Sprinklered ❑Ves ❑No 0 Req'd. 5. DESIGNER PHONE Valuation 10/ fs-4-ate' Building Arga�. Ft. • ADDRESS ZIP Main Floor Upper Floors Garage Area Storage - CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Area of Decks Finished Basement Unfin. Basement PKEW 0 ALT. ❑.AD N. ❑7t.. 0 MVE. 0 BLD. 0 PLMB. 0 MECH. CJ M.H. 0 POOL 0 OTHER • No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not q'd. DESCRIBE WORK 8. IV CO VALJA I N 9. SOURCE OF UTILITIES I� AS ELECTRIC WATER SEWER � Enum. Dist. I Location (Area) Ownership Public 0 Private lettli USE CODE 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 to give authority to violate or cancel the provisions of any other state or local law r.gulating construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION dad SIGNATURE OF APPLICANT DATE OF APPLICATION SPECIAL APPROVALS NAME DATE Env. Health SPECIAL CONDITIONS: Planning Fire Marshall Co. Engines Utilities Plans Examine SEPA Checklist PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building • Plumbing Mech.. Plan Check SEPA Mobile Home )o Other (Specify) nn 15° TOTAL $ PERMIT NUMBER 0.74 *5000 *50.006, . "A 1*Qo0 0 6.441.2 07-27:-82 2 64.79. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 1 1 6;442 z, *:50.002p PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL