1982, 04-12 Permit: 82A-0026 Relocate Residence PMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 2!1Za - 002C-.
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
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APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 2,14 is‘oeLEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION t PARCEL NUMBER/S ft-5-1 _\102_.
2. 2_ 1 'koF N Al:, 4 S
OWNER PHONE
3. C2.A(€€ L. 'CITE-OVS `"dei-`1stlW 1
ADDRESS i 7� ZIP Actual Set Backs in Feet 0 �)w��-� zs 1� 'Ffas.+k—
. . 3Z.2q LLrsER-T\) North g 'South Y
East v 'West 110
CONTRACTOR PHONE Size of Par el Zone Classification
c �
a. 104.,C) —Sem 1'c* P .
ADDRESS ZIP Type Const. ccupancy Spkl'ered
1/41‘1/4)1/4;
nr VI.) ?) Oyes ❑No 0 Req'd.
DESIGNER PHONE Va atio� Building Area in Sq. Ft.
C� 1
5. ji
ADDRESS ZIP Main Floor Upper Floors GarageAreaaStorage _
CHANGE OF USE FROM TO
1)(-1
rea of Decks Finished Basement Unfin. Basement
6. — ilLi0
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE I
W 0 ALT. 0 AD'N. 0 RPL. MVE. -
7. OF ❑ OTHER 1111
WORK BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Recd. 'Not R 'd.
of EXEMPTION II
DESCRIBE WORK , Dist. Location (Area) '
$ R j TE 2e41 E NCO' t4 /3?3ai @,, 8) FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEW R Ownership USE CODE
OF
9. UTILITIES I 'Ti,-C-- Public 0 Private Single $
I hereby certify that I have read and examined this application and have read the 'NOTICE" provisions included €: S im L/AL>
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building � Nit,'
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 INSPECTION } Plumbing
DATE OF APPLICATION (r/..,, - sr - SIGNATURE OF APPLICA - ....0001111MP'
ech.
SPECIAL APPRO LS /SPECIAL CONDITIONS:
NAME DATE C ��ryry+•��� n,A,q� y� Rom TM i� /�`� Plan Check
nv. H I Allei e/E -- j11)6.1/v Mo.U6A om I31 S T i-s?1U SEPA }.
Planning11 A, Ofti> D _ O
' Mobile Home LU
-J
sof J
Fire Marshall 6`�j_� ""(502,� "" �S �r {�7 '�', � _
. Ener
�' /' OA 'OA , ��` ) Other(Specify) CC
lit es' �I(11�L f .(�•1 0-,,,._ 0.-v- 1 H`S G,•4e. iiV�OAA- _
` �� C TOTAL $
Plans Examiner
tl✓ 62j7 -O4'2CEa ►°t EO " /7�2 WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklis THIS BECOMES A PERMIT.
'ng Technician PERMIT IS NONTRANSFERABLE
I PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
si,ve ,77
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