1982, 05-07 Permit: 82A-3557 Addition PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 1?52.I; -3G�
� NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
11V
')\ APPLICANT: COMPLETE NUMBERED SPACES - PRE*S HARD TO MAKE 4 COPIES
JOB ADD SS �.��� * `� L v O
�/ ! LEGAL DESCRIPTION - SEE ATTACHED `"
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. / j * c" 1. 00 .
OWNERa..- y f --64-4_-(.... 72,7-
72, �/
3 ADDRESS ZIP_ / Required Set Backs in Feet J .� f, Yc
- �--�'7� —� ///r,2,/k North 'South 'East (West J
CONTRA PHONE Size of Parcel Zone Classification (, — ,' (— �; G
-L.. -�-� -ZPH� -refs ;� '
4. ADDR S --yZIP / Type Const. Occupancy Sprinklered
/ ,r VI•2/4 4 ❑Yes ❑No 0 Req'd.
D SER PHONE Valuation Building Area in Sq. Ft.
5' r
ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPENo. Baths No. Floors No. Rooms Rec. Room
0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER
WORK ❑ BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK J FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities
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 constructs n or the ai-eO
performance of construction. Plumbing
!�
DATE `ci �--�� � SIGNATURES /" Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. ,y Plan Check
Env.Health / -_-CA G 4-
SEPA
Planning / .e -- W
Fire Marshall )
i . Mobile Home
Co. Engineer / W741 Other (Specify)
Utilities �� .(,,
TOTAL $ /-ems
Zone Clearance
WHEN MAC INE VALIDATED IN THIS SPACE,
SEPA Checklist ��� / 1� w THISt,�EC:•_I, A�F„�tMIT. 3,5 5'..7 z * 2 1.v 00
_1
DATE FFICIAL 9(7i'f,`, U I [ / /
APPROVED OR ISSUANCE —