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