1982, 02-03 Permit: 82A-794 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
litSPOKANE COUNTY — BUILDING CODES DEPARTMENT ga -7C(
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
'e.) APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
1. 5 . 33+ l,J+k- P_ 4 * * 2G,00
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2l}r r
'*' GF 'v to
OWNER PHONE
3. Tl-kCmia Ll t c:.i- Cv .:- �tcOi * 2 G 0 0 U
ADDRESS ZIP Actual Set Backs in Feet
3 , 3,3(1 L.A.DtLLzi,„sp, ct('A-2x)C. North ISouth East (West
CONTRACTOR PHONE Size of Parcel Zone Classification / 9, 3
4. �mM 02-03-82
ADDRESS ZIP Type Const. Occupancy Sprinklered
vrFatr✓S Oyes ❑No ❑ Req'd. `_ 6 4 7 9,
DESIGNER PHONE Valuation Building Area in Sq. Ft.
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. 0 AD'N. ❑ RPL. ❑ MVE.
7, OF / ❑ OTHER
WORK
0 BLD. 0 PLMB. MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
$^ZaQ�_ or.... Ae , V t� I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
' .9. UTILITIES Public ❑Private 0 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
.TE OF APPLICATIO ' 3x :� Mech. 9"''C�'
I�.�� � SIGNATURE OF APPLICANT ,��f I/"'�"'_'�' � 1 � �
.i l
SPECIAL APPROVALS SPECIAL CONDITIONS: �
NAME DATE Plan Check
Env. Health
SEPA
>-
-
rt._
C)
Mobile Home ',.1
Fire Marshall .i
Co. Engineer Other(Specify)
Utilities >
TOTAL $ f�_I<._J
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician���fPERMIT IS NONTRANSFERABLE 0 2h.'0 i-I8`2' '7 9,4 z *2 0,0 0 a
99�rl, PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL