1983, 04-18 Permit: 83A-3037 ResidencePLAN NUMBER
824 23e
(9
APPLIdATiON/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
1.
JOB ADDRESS
N. 4612 Lillian Road
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
2. 17 1 Peplinskis lst
Addn
OWNER
3Tupper Inc
Realtor
928E 1991
PARCEL NUMBER/S
#01541-0417
ADDRESS
East 12929 Sprague Ave.
ZIP
99216
Actual Set Backs in Feet
North 27' South
East
CONTRACTOR
Tupper _Inc, Realtor #TUPPEIR179DC
4.
EasfaR&S929 Sprague Ave.
PHY-1991
-1991
Size of Parcel
approx
-k I
West �,
Zone Classification
x 90 Single Family
zg9216
Type Const,
KI
Occupancy
R-3
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
rJ. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
979
ZIP
Main Floor
979
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
32 unc
Finished Basement
TYPE
7. OF
WORK
2F NEW
BLD.
❑ ALT.
❑ PLMB.
❑ AD'N. ❑ RPL. ❑ MVE.
❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
1
No. Tories
No. Rooms
2
Unfin. Basement
X1
No. of1 Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
X
DESCRIBE WORK
8. Single Family Residence
Enum. Dist.
Location (Area)
VALUATION
9. 35 , 448
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
ST
Ownership
Public ❑ Private IR
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 REVERSE SIDE FOR REQUIRED INSPECTIONS f�
DATE OF APPLICATION SIGNATURE OF APPLICANT�taC%Le'� 3�
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Her
n/ /i'o L-/31'3
Fire Marshall
engin 1'414
tilities
Plans Examin r
rt
S PA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
02* *281,00
*281,00
A *000
253-2
04-04.-83
12 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04 !-,1 8 -
DATE ISSUED
83' 303,75 *'281.002 -
PERMIT NO. TOTAL