1982, 04-26 Permit: 82A-3190 RemodelPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUIL' NG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
N , 4 i.t.)OO1..2u F
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. Cz (-Ls
ADDRESS
CONTRACTOR
�'i✓r/tC�
ADDRESS
A
DESIGNER
4.
CYR
PHONE
G7.c. — 43;2-s
PARCEL NUMBER/S
17541- k03
5. ADDRESS
ZIP
V • W 4Q'atz
Actual Set Backs in Feet
E.' IIVtI
North 'South East
West
PHONE
Size of Parcel
Zone Classification
ZI
ZIP
Type Const.
Occupancy
Zt�
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
ZIP
Valuation
SI
Main loor
000
C'
Building Area in Sq. Ft.
i a
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
❑ fyEW :Y/ALT.
��/BLD. ❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not ,eq'd.
DESCRIBE WORK
8. V t'L1'r^Er_.tc tvtoDE i_
VALUATION SOURCE GAS
[rja UTILITIES
OF
I hereby certify that' I have read and examined this application
Enum. Dist.
ILocation (Area)
ELECTRIC
WATER
SEWER Ownership
"35cPrt t. Public ❑ Private
USE CODE
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 INSPECTIO
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Na r •
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
14 07 CIt D .
SEPA Checklist
Bi{jldin ech�n
cKi—
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS: v_E+1C_ 7zN W�+t
1Z-1 eUS.,«.M-rE
rt 6F 1i+.aw.4tf'Q4.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$c„„.i.va
PERMIT NUMBER
82,A -30o
u2
*
* 61.00
* 61.00
31892
04-26-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0.426-82
DATE ISSUED
319,O1 *6LOOaI
PERMIT NO. TOTAL