1982, 10-01 Permit: 82A-8961 Insert PLAN NUMBER APPLICATION/PERMIT � PERMIT NUMBER
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SPOKANE COUNTY - BUILDING CODES DEPARTMENT //" 8 -Pc-t,C°(
JNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 0 4 * * 2 0, G 0
JOB ADDRESS
1. t--3\s V � Gtr 1p� LEGAL tESCF IPTION - SEE ATTACHED 8 9 6.0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 1 0- 0 1 -8 2
2. 6,479,
OWNER PHONE
3. ..-D`N3V _..._ coO,r.aSc.4t-) q `' t:
ADDRESS ZIP Actual Set Backs in Feet
• 1.J t5 git7f_lr..)," act-D.A.L North ISouthEast 'West
CONTRACTOR PHONE Size of Parcel Zone Classification
4'
ADD-•••0
DDS ESS ZIP Type Const. Occupancy Sprinklered
_y Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE No.Baths No. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. ❑ 'N. ❑ RPL. ❑ MVE.
7. OF �/ ❑ OTHER -
WORK ❑ BLD. 0 PLMB. / MECH. ❑ M.H. ElPOOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
, fDESCRIBE WORK Enum.Dist. Location (Area)
8. Y�6OP8i. QJI.)i")( L%. Z (2::( FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTI LLITIES� Public D 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 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 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" /O` / - 7.2 SIGNATURE OF APPLICANT �4G�""""[� ✓�-GDZ-�'Mech. .4=1'
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA >
Planning U
0
Mobile Home W
Fire Marshall
ti.:
Co. Engineer Other(Specify)
Utilities
TOTAL $7�`(26
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Bu• ing echni `
cia PERMIT IS NONTRANSFERABLE 1` 1-!.8 2
8 9 6,1 z *2 a o O a -31 -
'
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE 8 1 ISSUED PERMIT NO. TOTAL