1983, 07-21 Permit: 83A-6775 SidingPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS•
11 , 5 Lu -._E -e -o c.c)
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.-7ga
/0w ER
BLOCK
SUB VISION
£X O,
-� Z-
3. i / C f e. Y� C t;L�yL cLt 3 t�
ADDRESS
, 5 / 6,€).e-c-e-crzc)
CONTRACTOR
C LIai,,0r_ etro.i. • Lz=..
• ADDIR ESS �J
l C gO iL4_ /r O �d
DESIGNER d
5,
ADDRESS
PHONE
9ae.,=4/33,2-
PARCEL
4/,33
PARCEL N./AMBER/7
17154-3— a7/O
PHONE
Actual Set Backs in Feet
North !South
East 'West
Size of Parcel 1 Zone Classification
ZIP
99.2-iz
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation 1 Building Area in Sq. Ft.
ZI P
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N_
❑ MECH.
❑ RPL.
❑ MVE.
❑ M.H. ❑ POOL
OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. 6-1:.c...e_1' Sr 'd—
VALUATI N
9. 38/
SOURCE
OF
UTILITIES
Enum. Dist.
ILocation (Area)
GAS
ELECTRIC WATER
SEWE R
Ownership
Public ❑ Private ❑
USE CODE
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
tie of work will be complied with whether specified herein or not. The granting of a permit does not presume
ive authority to violate or cancel the provisions of any other state or local law regulating construction or the
formance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checkli
echnici
C
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
$5/
CC)
TOTAL $54
PERMIT NUMBER
02*
A
677,42
07-21-83
6479,
*5400
*54006
*C.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'7 �z2 rl'-8"3,
1,
677.5 Z
*54001H -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED, PERMIT NO. TOTAL