1982, 07-16 Permit: 82A-6082 Residence r
PLAN NUMBER
APPLICATION/PERMIT PERMIT NUMBER ��
7�` / O SPOKANE COUNTY — BUILDING CODES DEPARTMENT c
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
�' APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB AD 01 LEGAL DESCRIPTION — SEE ATTACHED
1. c ,. CSI VP*, ri/ �,-p0 2 * * 5 5 6 0 0
LOT BLOCK 'SUBOIV� ISION PARCEL NUMB
2. 0I ( pC7N196K0 piILVE, 0576' '( - -00(5 * 55600
OWNER PHONE A * c 0 0 �S
3. #6\r---r) L - -0 cam` �'. l q
AD RESS ZIP /_ Actual Set Backs in Feet 5 3
, �X 1 1,C, '(} 0:5-r Dt _ /� v'Q u-' North 7 'south J East (West l 06_L J j 2
CONTRACTOR 1 PHONE Size of Parcel Z ne Classification
4 ,0 h 1'C' . ,I)(.... 5 Li I2 - 6 G 7.(;;
ADDRESS ZIP Ty7¢oust. Occd
pancf Sprin❑Yes ❑No kl❑ Req'd.
DESIGNER PHONE ValuationillVBuilding Area in Sq. Ft.
s. 233 2';-;ADDRESS ZIP M in Flo r Upper Floors Garage Area Storage _
...-90 _._.,.
CHANGE OF USE FROM TO Area of ,f cks • Finished Basement Unfin. Basement
6. rf` 7(JNJki), 1 (c, '«'
TYPENo. aths o. Stories No.,00ms No.i f Dwellings
O*1�IEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE. --7
PJ
7. OF ,/ 0 OTHER
WORK L3 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL ERTIFICATE Req'd. Recd. N`t eq'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) '
8. CCS � +,0 - C I C 'e tJ I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES " �G.. Public ❑Private
`` '' 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 5r4 -
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 v"olate or cancel the provisions of any other state or local law regulating construction or the
performance of constr tion.SEE REVERSE SIDE FOR REQUIRED INSPE OPlumbing
r?,±A,
DATE OF APPLICATION V )(. 1.12., SIGNATURE OF APPLICANT G)---� `'�) Mech.
SPECIAL APPROV L I SPECIAL CONDITIONS:
NAME TE Plan Check
Epi. Health
Kea ,/' SEPA a
Planning C
Mobile Home U
Fire Marshall —
U
C En er Other(Specify)
SMA 03/t2.._
Utilities TOTAL $ 5
PI- 's ...41.miner
‘;, it j (0�.' -' WHEN MACHINE VALIDATED IN THIS SPACE,
S P• Checklist THIS BECOMES A PERMIT.
.��
` echn ia) PERMIT IS NONTRANSFERABLE 01. 14-1,2 6 0 8. 2 z *5'5 6.0 0 0
! -__,/ yrx � PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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