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1982, 05-21 Permit: 82A-3996 AdditionPLAN NUMBER APPLICATION/PERMIT ON/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 r S \ r- LEGAL DESCRIPTION — SEE ATTACHED LOT 2. BLOCK SUBDIVISION OWNER 3. (&i Fr'ok24C-� ADDRESS Com, 1�t7.� CONTRACTOR 4' ADDRESS OrJ PHONE c .4• -C A.1414- PARCEL NUMBER/S tAith f2"St•r-i 1�r+rV'�; L I•Z 1_i✓ C G `r RI . VII' c t tAit 2 tic ter : a L;j •24 S44 -.sem ZI P Actual Set Backs in Feet North ISouth°24.1.45-:-."East, 'West PHONE Size of Parcel t 5C� Zone Classification ZIP Type Const. N Occupancy t Sprinklered Elves ❑No ❑ Req'd. DESIGNER 5. ADDRESS PHONE Valuation +�33 Building Area in Sq. Ft. s ZI P Main Floor Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK iEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ OTHER BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not DESCRIBE WORK 8. Pht-2 ,-rt.or-74 tlIsk VALUATION 9. SOURCE OF UTILITIES Cli GAS ELECTRIC Enum. Dist. I Location (Area) WATER SEWER "prt C_ Ownership Public ❑ Private 11/ 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 SPECIAL CONDITIONS: NAME DATE Env. Health Plannin Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Building Technician PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building 7 Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 76 PERVIT. NUii.-BER 52A 3(1% 02* *75.00 *7500 re *75.006 A *0.00 399,5 05-21-82 647`c; WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 05-21-82 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED 3 6 * / TO PERMITNO.TAL