1982, 10-11 Permit: 82A-9378 ResidencePLAN PERMIT NUNiBER NUMBER
� r �® APPLICATION/ PERMIT Pgz.�-q 3—IS
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / ,r,POK_XNE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED * I r) 0 Y.
LOT BL K SUBDIVISION PARCEL NUMBER/S
2. 1
Ip (aterJ.,
OWN HONE
GCS L V , � — 0
3. '
ADD
ESS
Actual Set Backs in Feet�7�0
j
✓
!122-6"
North South East West `F)
(C/
CONTRACT R
PHONE
Size of Parcel
Zone Classification
��
4.
ADDRESS
ZIP
Type nst.
cctipancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
lyiain lgr I
Upper Floors I
Garage Area
Storage
_
CHANGE OF USE FROM
TO
Area pj Decks
Finished Basement
Unfin. Basement
6.
TYPE ❑
❑
W ALT. AD'N. ❑ RPL. ❑ MVE.i^
No. hs
. Stories
No. Rooms
No. of Dwellings
7 OF ❑OTHER
LI BLD. ElPLMB. 1:1MECH. ❑ M.H. El POOL
CERTIFICATE
Req'd.
Recd.
WORK
of EXEMPTION
I
INobReq'd.
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8.,.
VAL'UGTION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership SE CODE
9.
OF
UTILITIES
I
I
Public El 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
_
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
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
rE OF APPLICATION (� —�
Mech.
f SIGNATURE OF APPLICANT /`
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. ith
SEPA
Ian in
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
R—7' l --
Utilities
0
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Ch list
THIS BECOMES A PERMIT.
–g�?n g.,Te n1Scian
PERMIT IS NONTRANSFERABLE
1"o 16 "•82 9 3% 8 z
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