1982, 06-10 Permit: 82A-4817 ResidencePLAN NUMBER
yflel /aF
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
ES�� 2S i Sya�J LEGAL DESCRIPTION - SEE ATTACHED
LOT [BEO-C—K B O PARCEL NUMBER/S
2. A
OWNER
PHONE
�7 10 ,
3.
dk-m—,
ADDRESS
ZIP
Actual Set Backs in Feet
'?. 14-
North i'.20� South 4CO' East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
*c 7 7!,00)
* 0 ,n
4.
ADDRESS
ZIP
_Iy&e Const.
Occupancy
Sprinklered
C
i-
❑Yes ❑No ❑ Req'd.
DES""aNER
PHONE
Valu on
Building Area in Sq. Ft.
$ 144
% 100-
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
1 I Z.
-
--
.-.
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE /
Irl NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
i=ce
No. Stories
No. Rooms
rJ
No. of Dwelling
7, OF ❑ OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Rgq'd
of EXEMPTION
y�
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
VALUATION I SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership USE CODE
OF
9. UTILITIES1'\C_
Public El Private
Single $
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
210.00
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 APPLICATIO '?/' SIGNATURE OF APPLICANT
Mach.
SPECIAL APPROV LS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Ig►alt � � /C UTn7_ ��p1��t�2S�h�i��Y! ,2s'�G� rs��sr�Qi /wt/ �o-?�[�--�'�.
ng qL
Fire Marshall
Co. Engineer
rUtilities
Plans Examiner
inician PERMIT IS NONTRANSFERABLE
.0 � —
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
52 R 401-7 1
-
0._$
iC00
�7 10 ,
71t 0 y
/
-
1 ,7 C
*c 7 7!,00)
* 0 ,n
'^, rj `- is G
C
TOTAL $ ;L-)0.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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