1982, 06-08 Permit: 82A-4669 ResidencePLAN NUMBER
APPLIC 'TION/PERMIT
SPOKANE COUNTY ° UILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
1.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
. 8ti 08 L -t a -TY
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
OWNER
3, t- t' L.A`L4 COA 1 2l -c.0 X loov
ADDRESS
4b • 6`205 C.A. wwQ
CONTRACTOR
4.
PHONE
48 -JAZ
ZIP
aCA.-
PARCEL NUMBER/S . vg.7.42V c
j3L.IC 83 OQC A-koidlb .*3 € dVDO s TION
bCzork3—ern
Actual Set Backs in Feet
North 5C0 South
East S West t 01
PHONE
Size of Parcel
Zone Classification
A‘
ADDRESS
DESIGNER
FJ. ADDRESS
ZIP
Type Const.
Occupancy
1 -!m-►
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation
40,E -
Building Area in Sq. Ft.
14
ZIP
Main Floor
q7�
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
6560
U1in. Basement
TYPE
7. OF
WORK
EINEW 0 ALT.
LJ BLD.
0 PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. .16,, cd
Ftaw..«...1
Enum. Dist. I Location (Area)
VALUATION Ownership USE CODE
"<</�24- Public 1:3 Ownership
lel
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 constructicya'.pr the
performance of construction. SEE RE ER E SIDE FOR REQUIRED INSPECTIONS
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
C.15PK.0
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
77, K Ro L(_
Planning
Fire Marshall
Co. Eng
ilities
GAA2-
Plans Examiner
9etoTLE1/4)$1 r arailet
SEPA Checklist
Building T chnician
NATURE OF APPLICANT
SPE IAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Ailkk
FEES COLLECTED
Single $
Building 11"2,131.."
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ I. e�
PERMITI NUMBER
S2-takieci
0 2 *
,
465.8
06--0E -82
g> 6.479.
* 281,00
* 281,00
*281,00Y
*000
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• H
iQ8.t82a
0 �.
466.92 *281.002p'
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