1982, 03-19 Permit: 82A-1990 Pole BldgPLAN NUMBER APPLICATION/ PERMIT PERMIT NUN., 1=
s,xSPOKANE COUNTY - BUILDING CODES DEPARTMENT i
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
OT BLOC
2. '2
OWNER
3. -I�lv
4. ' `
AD
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
DIVISION PARCEL NUMBER/S
Ak
P(iONE
DRES _ ZIP Actual Set Backs in Feet
North South 5;17J/East w rG West
TRACT
DESIGNER
PHO N
Size of Parcel
Valuation
Zone lass ification
lr ��/
ZI
Type
V
onst.
I
Occancy
M1
Spr nkler d
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area infScl Ft
5.
01?s'
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Stora e
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Baseml
6.
No. Baths
No. Stories
No. Rooms
No. of Dwe
TYPE EW ❑ ALT. ❑ AD'N.
❑ RPL.
❑ MVE.
7, OF //
E] OTHER
CERTIFICATE
Req'd.
Recd.
XBLD. ❑ PLMB. ❑ MECH. ❑ M.H. El
WORK
I
INotFZ
I�
of EXEMPTION
DESCRIBE WORK�f
)
Enum. Dist.
Location (Area) FEES COLLECTED
8.,c�:
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership SE CODE
OF
9. UTILITIES Public ❑ Private
Single $
1 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
(y./y/ /d/ Plumbing
nATC nr ADDI WATIf1Nl l / J '"-,'l CIrNIAT1IDC nr- ADDI 1/'AnIT .4 d"iEl /1� '�--i'^ 4 Mech.
SPECIAL APPROVALS
NAME DATE
Env. Health
Plannirfg
Fire Marshall
Co. Engineer
ns Examiner
Buildin ec5icrlarr',) jam_
SPECIAL CQNDITION
r"t.""5 r
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
ngs
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
. - .
�
| �
i !
Each Small Square Equals 3 Inches
Diamond Industries PLANNING SHEET
/
SPACE xFOR
UN/TS REQUIRED ADDRESS
/ _----___-_� -__--_--__-
DATE
D+ 512
'
/
-
Cz �
�V
Each Small Square Equals 3 Inches
Diamond Industries PLANNING SHEET
/
SPACE xFOR
UN/TS REQUIRED ADDRESS
/ _----___-_� -__--_--__-
DATE
D+ 512