1982, 09-22 Permit: 82A-8563 MH PLAN NUMBERAPPLICATION/PERMIT PERMIT P-'UMB
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
�3 —B',7627
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
(1)// APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
NII
JOB plo,DRESS y x ( `l
1. I - 309 ,� , 19 LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION. �1 PARCEL NUMBER/S t- (- =
2. A 0\A 1 /$‘'' V�J-r I 0;2_04-
L '''a , ? 2
OWNER s PHONE! n I/ 6� '� 5 # Ac,
cz C LI/ C
3. f
AD��55 V307
p� Actual Set Backs in Feet
K IC/ ��4 North ISouth2 East I-7 (West
COR HONE Size of Parcel ne Classification
<17-4r,9 3Q, K 2---c2 .) f(11"1-"-
4. ADDRESS ZIP Type„C st. Occupancy Sprinklered
,'VIS 7� ❑Yes ❑No 0 Req'd.
DESIGNER PHONE ValuationBuilding Area in Sq. Ft.
5' �/ �ADDRESS ZIP Main Floof UppeFloors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
NEW 0 ALT. 0 AD'N. ❑ RPL. 0 MVE.
7, OF 0 OTHER
WORK ❑ BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Reg' . Rec'd. Not Req'd.
_ of EXEMPTION r_
DESCRIBE WORK r.' num.Dist. Location (Area)
// `"3� I FEES COLLECTED
8. VALUATION �SO E t€ ECTEI WATER�_ � wnership 1 E CODE
OF
9. UTILITIES '” Public D 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 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 APPLICATION 7 -- 7, }'— �/ z- SIGNATURE OF APPLICANT",�12,�//�f,/ Mech.
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SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE ry �+y y/ hh��� lPlan Check
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'pif / 011 � , r SEPA
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ire ars all j):,34,1-16-z:2,4‘,04 -8.20 q/� �/ �0,(E.. / � Mobile Home "-
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Co. ngin r Other (Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
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ing Te ici PERMIT IS NONTRANSFERABLE . O•.9'-'.2 2 8 2 8 56.3 5 * 5 Q,.o Q a
'`- — PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL •
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