1982, 10-28 Permit: 82B-0278 Residence7'LAN NUMBER
APPLICATION/PERMIT •
SPOKANE COUNTY -- BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SIPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3•COPIES
JOB ADDRESS
LOT
2. 'z
BLOCK
1
1'1.1 N \eicv.ltcs—
SUBDIVISION
t -a Lw t.,6T5 ADb tTtoN
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3. 1•30c -t-. Gt S t e_LA. c_ -c, r *I
PHONE
OIZL. - %SG, I I)
PARCEL NUMBER/S
\$4�) 4-702
ADDRESS
E - q"zt.. TIZrN<
ZIP
l(c17eg
4.
CONTRACTOR
Sr*h4E
PHONE
ADDRESS
S (A144 -E
ZIP
5.
DESIGNER
PHONE -
Actual Set Backs in Feet
North (South 30East 1West I O'
ADDRESS
ZIP
Size of Parcel
Pv xt4i.
Type � Const.
-7].IJ
Occupancy
Vgiqation
.{ gee
Main Floor
452-
•
Zone Classification
�t t�GLLB lritk
5 prinklered
❑Ves ONo 0 Req'd.
Building Area in Sq. Ft.
as -2
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
' Area of Decks
Finished Basement
Unfi�n. Basement
-r /4
TYPE
7. OF
WORK
BLD.
BLD.
DESCRIBE WORK
❑ ALT.
❑ PLM B.
❑ AD N.
❑ MECH
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
'❑ 01 -HER
No. Baths
2
No. Stories
X
No. Rooms
4
No. of Dwellings
CERTIFICATE
of EXEMPTION -
R eq'd.
Recd.
Not- Beq'd.
8.4asNGLe-
-FWYvuL'.!
12'EF i OEI.1C6
Enum. Dist.
Location (Area)
VALUATION- SOURCE GAS ELECTRIC WATER SEW.JER
OF
9. UTILITIES
Ownership
Public 0 Private IV
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 cor local law regulating construction or the
performance of construction: SEE REVERSE SIDE FOR REQUIRED IIT-sPE
DATE OF APPLICATION 10 al SIGNATURE OF APPLIICA
SPECIAL APPROVALS
NAME DATE
Env ea h
X /O/Z 7
Planning
Fire Marshall
Co. Engineer
)c . ArocenEorr io�at�
Utilities
Plans Examiner
ON' Kt
SEPA Checklist
uildln Tech f
im 4:4
SPECIAL CONDITIONS:
S
Inspection of forms before pour is required
PERMIT IS NOINTRANSFERABLE
PERMIT EXPIRES ONE NEAR FROM DATE OF ISSUANCE
J
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ Z•QO
PERMIT NUMBER
0�171 •—o23B
02* *24'600
*246006
A *000 3
994.1. •
10-20`82
'2 647'9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ttit
1110,•712.8 8;21
DATE ISSUED
2'7.82 t24,6,OO°°,
PERMIT NO. TOTAL
4-
fi
14
\
4 1
(---)f N:ck '1.'11 ;. • ::-1,. .k.
- .
:'1:.',,, A: \ i':•-•\•
loo
1/
h!
ft
4