1982, 04-15 Permit: 82A-2844 Wood InsertPLAN NUMBER UMBER
APPLICATION/PERMIT PERMIT N_
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
e
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. `'J_ �r'i Sctn� .5rLEGAL DESCRIPTION —SEE ATTACHED
O`WrNER
3. 1 tklZS00
ADDRESS
CONTRACTOR
4 't"NE c
PHONE
ZIP Actual Set Backs in Feet
North South East
PHONEJ'��y Size of Parcel Zone
ADDRESS
ZIP
Type Con:tj
Occupancy
Sprinklered
. 14--124 ' �� [hLOK-2-2,0-2-❑Yes
❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
Baths
No. Stories
No. Rooms
No. of Dwelling
TYPENo.
NEW ALT. ❑ DIN. ❑ RPL. ❑ MVE.
7 ❑OTHER
-1
BLD. ❑ PLMB. IECH. ❑ M.H. POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
8.ir7L3c�c2� ct�C l
FEES COLLECTED
VALUATION
SOURCES
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
I UTILITIE
Public C1Private ❑
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
DATE OF APPLICATION SIGNATURE OF APPLICA
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA c
Planning t
L
Fire Marshall Mobile Home
L
Co. Engineer Other (Specify)
Utilities
TOTAL $ i -
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
t
6ing,,s hnicia! . ` PERMIT IS NONTRANSFERABLE 0j4 —(1 5 8.2 214 4 z * 2 0, 0 0 d F