1983, 03-24 Permit: 83A-2187 AC PLAN NUMBER
APPLICATION/PERMIT PERMIT NUMBER
el SPOKANE COUNTY - BUMMING CODES DEPARTMENT ' '- 7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRES t 1�� �"
1.
T`c, (,c LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/5
2. ) 1,0A 1
3.
ADDRESS _ P Actual Set Backs in Feet
fl J�fX
[; - i � �
( � r: —e / �' /�Itr/ North (South East (West L' 4 * * 1 4. 0 0
••NTRA OR ,,, / P 0• Size of Parcel Zone Classification * 1 4.0 0 chi
4. ADO �BES 1 Z Type Const. Occupancy Sprinklered * O.O l
L> - , (! •� I L tQ,1% f
Y(/_ 1 4 ❑Yes ❑No ❑ Req'd. 2 1 q h
DESIGNER PHONE Valuation Building Area in Sq. Ft.
0 ,-24-83
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage 6 4 7 C _
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. 0 RPL. 0 MVE.
7. OF 0 OTHER -
WORK ❑ BLD. ❑ PLMB. %MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK /1 l 1' - Enum. Dist. I Location (Area) '
s C ,�}IL/, FEES COLLECTED
VALUON t
SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private 0
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,._ .2 -g 7) SIGNATURE OF APPLICANZiL
T" �`.!J Mech. l 4`)
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE 1/1;11
� Plan Check
Env. Health '
SEPA
Planning CD
_ U
Fire Marshall Mobile Home W
J
Co. Engineer Other(Specify)
Utilities
TOTAL $ 16.
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
• c .n PERMIT IS NONTRANSFERABLE o f3J-12 q, —8,3 218, z * 14 0,0 ° - -
.-.-`
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL