1982, 09-28 Permit: 82A-8787 Foundation, Joists PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 64 - S- 7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 DATE ql:7—g182--
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
i• 9
1. 6CI<•JOB AD RESS g � « LEGAL DESCRIPTION — SEE ATTACHED {i 2 * % V, ' v`
,
LOT BL�O,�C�Ke SUBDIVISION dd •
PARCEL NUMBER/S * 0 0
77,
OWN R PHONE '
3. ?.G� �L-1.h,i.�-^'s-.- y Y,y X A V c, __
ADDRESS ,/ ZIP Required Set Backs in Feet
�7 /K (West �, r— ^
A. Gv� 7:-/LA/4„...d..-0‘. % —z"' North /•S ISouth 5— East .30 2
CONTRACTOR PHONE Size of Parcel Zone Classification i
t� a 7 T
a. �& n, .-- y.),C1'-‘o yd . --
ADDRESS _ �,!' �/ ZIP Type Const. Occupancy Sprinklered
// kGf 9 G (/4'�L.G7 w.zy 5.44-14,--", 9 9 :2 a Cr ) .1,2_,-- , ❑Yes ENo ❑ Req'd.
DESIGNER PHONE Valu tion Building Area in Sq. Ft.
5. O r 3 602.5 _
ADDRESS ZIP DWL Area I Basement Area Garage Area Storage
Ce-Z5
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6. —4/ �' __
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW , ALT. ❑ AD'N. 0 RPL. El MVE.
7. OF ❑ OTHER -
WORK 0 BLD. El PLMB. ❑ MECH: 0 M.H. El POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION I✓
DESCRIBEWORK FEES COLLECTED
i
VA,VATION Source GAS ELECT IC WATE SEWER
of
9. ,_$ 1) Utilities Single 9 $ —
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 # 54-00
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
Plumbing
performance o constr tion.
DATI `' s IraSIGNATURE ( :—.r.— 44.144.i r !Aik Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
'----P011$*0 SEPA CD
Planning -,
Lo
a
Fire Marshall Mobile Home v)
Co. Engineer Other (Specify)
Utilities
TOTAL $ S4-.0o
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist ///��/� THIS OIVt P MIT. Q7'Q.
DATE ,/ �DFFICIAL9�1�9( <, Uy� �� J r `. ` Si • * 5 4 0 0 a -12
APPROVED FORGGGGGGORISSUANCE -