1982, 04-22 Permit: 82A-3068 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT F!UMBEP
K — SGI €(.;9..A- - �p68
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
N/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS_ / ki�9Y * } 3 z U O
1. ;3 �� �/ !� LEGAL DESCRIPTION — SEE ATTACHED a. 3 / 2 0 0
LOT BLOCK SUMIVIS ON PARCEL NUMBER/5
2. 1 Y1(4} 1°7[1 1 3��`Z -5 .01 * h200�
NE
3. D —4. 0114 H[ail et-Li �- -X063 S
h * C 0 0 8
(,�ADgfR S 7`�7� P, Actual Set Backs in Feet",.._ ,r 2 9 1,L.
1 � �� r" � North to 'South East `� (West
CONT T R C4+ PHONE Size of Parcel Zone Classification 0 4— 1 9- 8 2
C35 7c `72 4146IL& 1 :_?: 6.L 7 c
ADDRESS ZIP Tonst. Occup nc Sprinklered
V � 1 ❑Yes ❑No 0 Req'd. 1
DESIGNER PHONE Valuati & A O Buildinglren Sq. Ft.
cg
5 ADDRESS ZIP M i Floor Upper Floors Gara Area Storage _
CHANGE OF USE FROM TO fhecks Finished Baseme`t Unfit?. Basement
6. I 4-3(—
TYPE No. aths No. 5 ories No. ooms No. of ifwellings
LXN W ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. L
7. OF 0 OTHER CERTIFICATE Req'd. Rec'd. Not Re d.
WORK BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL
of EXEMPTION
DESCRIBE 12 6 VY Fo Enum. Dist. i Location (Area) T
8FEES COLLECTED
VALUATION
SOi1RCE GAS ILP_.
E TRIC WATER SEWER Ownership 1115E CODE
OF
9. UTI LLITIES ivvei�,UPublic ❑Private LAS/ 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
give authority to violate or cancel the provisions of any other state or local I. , egulating construction or the
rormance of construction.SEE R VERSE SIDE FOR REQUIRED INSPECT 0 Plumbing
DATE OF APPLICATION / ''"-- SIGNATURE OF APPLICAN /Agis.i� lMech.
SPECIAL APPROVALS SPECIAL CONDITIONSS
NAME DATE CO3N‹ VIC `` ,A 1 ''.4-t'' ' I,Q6'/
Plan Check
Envid;lita, W.2.(
SEPA
o_
PI Hing O
U
Mobile Home "i
Fire Marshall —
w
Co. Engineer Other (Specify)
Utilities -,/e,.....
TOTAL $ ✓6 —"
Plans Examiner
--(ANA rfl jwAr( WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
ildi� j .ia�? } `,0x.4�,.2,`.}�1--"8l 2 3?0 6 8-Z: *3 6 .0 0 a, _
�"/ PERMIT IS NONTRANSFERABLE G c
/� r• PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
-J.10 S I,1.71A
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