1983, 02-17 Permit: 83A-1159 ResidencePLAN NUMBER
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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
1.
2.
3.
JOB ADDRESS
�. �^1 C�t� \'►�eo��u -
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
2.
LOT
OWNER
C -7.c2 V 9 T1 tie C c'l
ADDRESS
--4-'S£0CfzC,2 /V
SUBDIVISION
`a' RaS pc,T
PHONE
q $I1Z
ZIP
act 3--1
PARCEL NUMBER/S-,2:5A.r _0"Za��
Actual Set Backs in Feet
North I V. South
East •-••'-'• 'West
4.
CONTRACTOR
ADDRESS
PkNt
DESIGNER
5. ADDRESS
PHONE
Size of Parcel Zone Classification
I'A is LSC: Aii:V(w f rvckt-E. FAAA:
: Ly/
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
PHONE
ZIP
Valuation
"712,423
Main Floor
BuildingtAreain q. Ft.
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
f4 o C c vtatc.
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
it/
N E W
it BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
1
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not R�{d.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
Enum. Dist. l Location (Area)
-A Tt-a;c..1..4cv0
GAS
ELECTRIC
WATER
SEWER
C_
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
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 constru on or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION .� C)�)' ? SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
L.'(l\) Le -i
Planning
Fire Marshall
Plaii,,,
/Ek7iner
SE A Checklist
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
PI mbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
4
TOTAL $'fes
PERMIT NUMBER
02* *4A00
*40'9006
A *( 00 S
92.7
'02,-08-82
g 6.47'9
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'2.j,?12t -8'3
DATE ISSUED
115.92 *409.002,p' -
PERMIT NO. TOTAL
Lincoln Mutual
Savings Bank
PLOT PLAN
LEGAL DESCRIPTION: LOT s 8LK 2
NI -cc -LC No 325¢/- 2205
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NAME• or2DoN 5NC# 928-S/77
ADDRESS. -S 37x6 G' 0004'4 ''A
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