1982, 07-26 Permit: 82A-6416 MHPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUliDiNd CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3
4.
JOB
�✓AADDREVVSSev�!v�',\/%/
1915<37
LOT BLOCKCISUBDIVsION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
r . 5
DrRES
r tM
3 2 ��tV k1
COe...ZA,CTOR
HONE
.-y/374-
P.°1
NE
PARCEL NUMBER/SV _j 7� i , �! i ,-. C^ -('- I
�/C[?� nl .)
(t—
Actual et,Backsin Feet
North (/ (South East (West 71.4 0
Size of Parcel 7' Zope Classification
loo4,3
ADDRESS
ZIP
Tygel nst.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
ZIP
u//n-u 20
Main Floor
Building Area in Sq. Ft.
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
if NEW ❑ ALT.
0 PLMB.
❑ BLD.
❑ AD'N.
O MECH.
❑ RPL.
M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
No. Rooms
Req'/
No. of Dwellings
R�.
Not Req'd.
DESCRIBE WORK
8.
VA UION SOURCE
OF
UTILITIES
14041. AS
s. - Oa)
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
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
2 -41 -?c. +0)
ELECTRIC
Enum. Dist. 1 Location (Area)
II
WATER
SEWER
Ownership
Public 0 Private
USE CODE
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
EOta2
7/,q ,
Planning
Fire Marshall
CQ, Engineer{
Utilities
Plans Examiner
SEPA Checklist
l
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
+ II
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home Ivn
Other (Specify)
TOTAL $
PERN(IT NUM,tER
07* *10000
*10000
A *C00
6255
07-21.82
61t7c
.04
•
(NHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6 8'2
DATE ISSUED
641,62 100.00217'
PERMIT NO. TOTAL