1982, 11-29 Permit: 82B-1411 FencePLAN NUMBE".
APPLICATION/PERMIT
SPOKANE COUNTY — BUMMING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
ovj ,{�vIJ 'BVI
1 •
LOT I-7OCK SUBDIVISION
2.
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 1,0Y
3.
OWNE
k S J -10-1
ADDRESS
f', 1702
CON T1 R
4' ADDRESS +I� j��J�
c)67hirr
PHONE
0
Actual Set Backs in Feet
North 'South East 'West
PHCSNE
ZI P
Size of Parcel �ZoRe�Classification
IC ?< ? C� ��-51.J1.7-
4,,Ipancy I Sprinklered
TyNgInst.
Elves ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
Main Floor l Upper Floors r Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ OTHER
tgl BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE w
8.
VALUATION
9. *770
ORK
7 - 1`
Enum. Dist.
Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private
/CJSE 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
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
DATE OF APPLICATION/ O�7 4 SIGNATURE OF APPLICAN
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
12•4(<)
SEPA Checklist
Id'
�lt\J mro.r 1r. \( 157- E32-7
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Pian Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
,- 14—!I
02* *2000
*20.006
R *000
1 [t 1, 0
2 647'9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
l°1' -x'29-82
141:1 Z *20.00.a -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
t2ao Appy-
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