1982, 10-28 Permit: 82B-0312 SidingPLAN NUMBER
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
1. S. 2.(01 4- Pi Nes
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. LPsza (
— rr,SSMcsac
PHONE
Cite-4Y.s,.aly
PARCEL NUMBER/5
Z 054 toot
ADDRESS
5.2!.14
(�1NES
ZIP
Ggtzcw
Actual Set Backs in Feet
North 'South
East
(West
4.
CONTRACTOR
�VJE1.1ra WC Tea...a
ADDRE�tSS�v.�.
S. Tt\ C0R.CES:
Ce -S.
PHONE
ctz,e �.
Size of Parcel
ZoneClassification
F..EA.Q?wS.
ZIP
GGZcC
Type Const.
Occupancy-
- J
Sprinklered
❑Yes ONo 0 Req'd.
DESIGNER
5.
ADDRESS
PHONE
Valuation
2r
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
19 NEW 0 ALT.
ZBLD. 0 PLMB.
o AD N. IO RPL.
0 MECH.
0. MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Ryq'd.
DESCRIBE WORK
8. REPO -Pi£ sifl'NG
} VALUATION
9' Z'C00
SOURCE
OF
UTILITIES
Enum. Dist.
Location (Area)
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private
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
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. 440'Ca
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 40.00
PERMIT NUMBER
$2'Ci-031a
02* . •40.00
*40.008
A *0.00 3
31.1
10-28-82
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 i
1'0'2''81-8;21 312 5
DATE ISSUED PERMIT NO
*40.0OaO..-
TOTAL
Y
0-
0
0
W
LL.