1982, 08-06 Permit: 82A-6858 Special InspectPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BOLDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 -COPIES
1.
2.
3.
4.
JOB A(D?RJo
LOT BLOCK
(• 46„,tni�l.
rUBDIVISION
LEGALDESCRIPTION - SEE ATTACHED
OWNER
ADDRESS
I �D
RP\
CO R5 V
HONE
v/ I�
HONE
PARCEL NUMBER/5
Actual Set Backs in Feet
North (South
Size of Parcel
East
IIP/est
Zone Classification '
ADDRESS
ZIP
' Type Const.
Occupancy
Sprinklered
❑Yes DNo 0 Req'd.
5.
DESIGNER '
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors .l Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
LJ NEW 0 ALT. 0 AD N. 0 RPL. ❑ MVE.
❑ PLMB. IJ'' MECH. ❑ M.H. ❑ POOL
°WV
0 BLD.
DESCRIBE WORKa. .s2 L i d�� r T[ oN)
VALU ItN SOURCE GA ELECTRIC
OF
9. UTILITIES
LYOTHEft
No. Baths
No. Stories
No..Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist. I Location (Area)
WATER
5 ER
Ownership
Public 0 Private 0
USE CODE
Thereby certify that 1 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 a.: rdinances governing this
type of work will be complied with whether specified herein -or not. The grantin..f a .ermit does not presume
to give authority to violate or cancel the provisions of any other state or local I•' regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT! NS
DATE OF APPLICATION gG - r% Q- SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
SEPA Check!
FEES COLLECTED
Single $
Building
Plumbing
Plan Check
SEPA
Mobile Home ,r7��
Other (Specify)_cf5r' —
TOTAL $ 0
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
PERMIT NUMBER
eza - &058
02* *R00
6857B
X08=06-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE, -
THIS BECOMES A PERMIT.
0; 8,;*10, 61=
DATE ISSUED
•
6i85.8Z
PERMIT NO.
%80'0 -
TOTAL