1983, 04-29 Permit: 83A-3432 ResidencePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILbING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. N. 4621 Lillian Road
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2. 10
BLOCK
2
SUBDIVISION
Peplinskis 1st Addn
3.
OWNER
TUPPER INC REALTORS
PHONE
928-1991
PARCEL NUMBER/S
0/5-4/- 06-i0
ADDRESS
E. 12929 Sprague Ave.
2199216
Actual Set Backs in Feet
North 12' 'South tEast 'West 25'
CONTRACTOR
4TUPPER INC REALTROS #TUPPEIR179DC
ADDRESS
E. 12929 Sprague Ave.
PHONE
928-1991
Size of Parcel
140 x 85
Zone Classification
Single Family
ZIP
99216
pe Const. V
N y
Occupancy
R-3
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
ZIP
4tation
--14-04
Upper Floors
M 940 or
Building Area in Sq. Ft.
940CS
Garage Area
528
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
32 unc
Finished Basement
Unfin. Basement
884
TYPE
7. OF
WORK
ANEW 0 ALT. 0 AD N.
❑ :3LD. 0 PLMB. 0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
2
No. Stories
CS
No. Rooms
4
No. of Dwellings
1
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
X
DESCRIBE WORK
8. Single Family Residence
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
\G
Ownership
Public 0 Private E
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 or local law regulating construction or the
performance of construction. SEE REVERSEERSIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION ‘"\---c---(-2) SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health [�
ll , 1
Planning
Fire Marshall
Co. Engineer
Utilities
W.2.5
Plans Examiner
c riLa
SEPA Checklist
i nicia `A
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 4tt7
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ i+1(o.to
PERMIT NUMBER
g2J4� ' 3432-,
(„ -
c 77
0 0
is
? 5 3
7
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Pti r'. #
04-,29=83 34125 *296.0021-2 -
DATE ISSUED
PFRMIT Nn TOTAI
0
0
C