1982, 01-22 Permit: 82A-609 Special InspectPLAN NUMBER
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
1.
2.
JOB AgDR SS
I 2-0� M / -\ x (1\61,1-
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
3.
4.
OWJClR C2N 1�7 N'G) p MIv I1 JK-
ADD�-($
Flr • // rJCX f 3 3
CONTRACTOR
'HONE 4gzfr
Z P7DO0
PHONE
PARCEL NUMBER'S
Actual Set Backs in Feet
North' 'South
Size of Parcel
East
West
Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Ves ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuation
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
7.
TYPE
OF
WORK
O NEW
O BLD.
O ALT.
❑ PLMB.
O AD N.
O MECH.
O RPL.
O M.H.
0 MVE.
0 POOL
LJ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
B. /XV 1,11 3Pr_i-60 J
9.
VALUUAA JON
Enum. Dist.
'Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
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 construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
1
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
o. Engineer
Utilities
Plans Examiner
SEPA Checklist
Via.- —' echnVa�'��•�L
SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
iJ& ItJ I1 -AI OF � ' ice 0\1,u -r
srC 1d5r,
Y' 'v
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
•
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Od
Other (Specify)
TOTAL LC✓ r• $
PEYt MIT N MBER
02*
A
G 2 - coo,'
*800
*800 1
*Q00 S
0.82
01-22-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,011151 121 8�2'I
6,0,9 Z
DATE ISSUED PERMIT NO.
*8.00 as E.
TOTAL
0
U
J
LL