1982, 04-21 Pemrit: 82A-3032 WeatherizationPLAN NUMBER APPLICATION/ PERMIT PERMIT NUMBER
SPOKANE COUNTY - IUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
v APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOBDDRESS
�, 13803 VW o LEGAL DESCRIPTION — SEE ATTACHED
2. 10 I 1
OWNER
3. 15VJ 1
AD SS
CONT�F}CT R
BDI SION PARCEL NUMBER/S -
'(12Yai`6i�D� C>EZZG� 2 V r r
Actual Set Backs in Feet
��JJ77 North South
PHONE Size of Parcel
SPECIAL APPROVAL
IS
NAME DATE
nv. Health
Planning
Fire Marshall
o. Engineer
ns Examiner
SEPA Checklist
Building cnni 'yw .�
rT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
*2000c
A
JUJ. -
i, 27 F,2
6.479.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 41y�2 l'i- $ 2' 3 0 3.2 2' * 2 0.0 0 01-j -
rvvis -
4' ADDRESS I
ZIP
Typ�Cbnst.
O cupancy
Sprinklered
�(N
/J,)i
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
s.
No. Baths No.
Stories
No. Rooms
No. of Dwellir
TYPE ❑ WALT. 13 AD'N. ❑ RPL. ❑ MV E.
7, OF El OTHER
_/
F� BLD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not R '
WORK
of EXEMPTION
I
DESCRIB
WORK
Enum. Dist.
Location (Area)
$
�
��
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC ATER
SEWER
Ownership USE CODE
9. 000
I UTILOITIES
Public 11 Private
t
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions incl]ed
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governingBuilding�0
type of work will be complied with whether specified herein or not. The granting of a permit does not preto
give authority to violate or cancel the provisions of any other state or local law regulating construction o
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
Plumbing
&2j121/ZlZ
DATE OF APPLICATION SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVAL
IS
NAME DATE
nv. Health
Planning
Fire Marshall
o. Engineer
ns Examiner
SEPA Checklist
Building cnni 'yw .�
rT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
*2000c
A
JUJ. -
i, 27 F,2
6.479.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 41y�2 l'i- $ 2' 3 0 3.2 2' * 2 0.0 0 01-j -