1982, 08-03 Permit: 82A-6736 Special InspectionPLAN 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
' JOB ADDRESS j r LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK
2.ISUBDIVISION PARCEL NUMBER/S
OWNER PHONE
3. 11
WD'b RESS ZIP Actual Set Backs in Feet
North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors I Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
s.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
❑ NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
], OF EJBLD. 1-1PLMB. ElMECH. ElM.H. ElPOOL OTHER
WORK CERTIFICATE Req'd. I Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
$ FEES COLLECTED
VALUATION SOUR GAS ELE RIC WATER SEWER
OF Ownership USE CODE
9. JUTILITIES Public El C3
Single $
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 Building
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 Plumbing
DATE OF APPLICATION � N t'" _
SIGNATURE OF APPLICAhlt 0�4 }1U Mach.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Build in ech clan
. .-e�.
PERMIT NUMBER
9,-2A - 6-7 3(,,l
02* *800
*800
A *0,00
673,5.2
08-03-82
6.479,
SPECIAL CONDITIONS:
Plan Check
Mobile Home
C
Other (Specify)
J � L TOTAL $ d
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE 0 8— 0 -'8'2 6 7 3, 6 z
*8.00a-�J-