1982, 06-04 Permit: 82A-4503 Addition (PLAN NUMBER APPLICATION/PERMIT (PERMIT NUMBER 3
SPOKANE COUNTY BUJLDIAG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
el
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS o * d j (} 5
1 Y fQ2, 1jp J LEGAL DESCRIPTION — SEE ATTACHED • U
2. LT BLOCK SUBDIVISION PARCEL NUMBER/S Oh c o
3 ✓ I �,'�/1cL A2of -i 1" * bl00
OWNERO E
3 AD RESS �Iy / P P Actual Set Backs in Feet �2 6 5 1,
I o z "���� North (South East 'West 1'-`
CONTRACTOR PHONE b Size of Parcel Zo Classification 0 —
6 if 2
a. "O K 1C-.., 47 c
ADDRESS ZIP Ty kInst. Cccupancy Sprinklered
`\YYAA 42'�j ayes ❑No 0 Req'd.
DESIGNER PHONE Valuatio !/�_ Building Area in Sq. Ft.
il
5. ADDRESS ZIP Mainr Upper Floors Garage Area Storage _
6
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. _._
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
❑ fy£W 0 ALT. AD'N. 0 RPL. ❑ MVE.
7. OF lit
❑ OTHER -
WORK BLD. 4 0 PLMB. 0 MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. ILocation (Area) FEES COLLECTED
8. 1i 1 bn\c-t S 6-4464}1-r) -1-Cr t-'o
VALUATION SOURCE G ELECTRIC WATER SEW
OwnershipSE CODE
OF
9. UTILITIES WC 16`".." Public 0 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 �� gi_ g� SIGNATURE OF APPLICANT \if / ,,\2? Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
. Healtihk n
// ..�} 'Ea_ NO'IM,E. tx...upq-TlO ANDA DS SEPA
t, •lanni /�0(-3142__�' C
Fire Mars al Mobile Home LL
U.
Co. Engineer Other(Specify)
Utilities
TOTAL $ / 1
'Ian amin: /,
.7.----) WHEN MACHINE VALIDATED IN THIS SPACE,
( SEPF�,.Cehecklist THIS BECOMES A PERMIT.
ti
_. _ g Tec r PERMIT IS NONTRANSFERABLE 0C4114-:--'81.2' 4 5 0.3 z ` * 6 10 0 a PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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