1982, 10-04 Permit: 82A-9066 MH PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT ac6,4,
elNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. E. hj it5°_7.: Seo f LEGAL DESCRIPTION - SEE ATTACHED C
LOT BLOCK SUBDIVISION l * * 5000
�y n / PARCEL NUMBER/S
2. 5" 1 Ct V E At-t-c-i C i IA's 9 0 6 5
OWNER PHONE
3. VI. €. tS. :a2-t-t-lc--( q2, ,.-s 1G153Z- 1 i o5 1 0 0 4-8 2
ADDRESS ZIP Actual Set Backs in Feet..xl Y 6. () 7 9
.) . 2.-z_ Jc t4..,-Pc---1 (7.,--T\.-� �G'/Zd6 North 'South East (West
CONTRACTOR PHONE Size of Parcel Zone Classification
4. S4kr '74.OzX v2-7.5 .R0.
ADDRESS ZIP Ty e Const. Occupancy Sprinklered
. Y".e. TZ 'R•-3 Oyes ❑No ❑ Req'd.
DESIGNER PHONE ValAVion Building Area in Sq. Ft.
5. 51 r Do .-7' .a
ADDRESS ZIP MaaiFin�Floor` Upper Floors Garage Area Storage
- — ..�'"".
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE No.laths No. Stories No. Rooms No. of Dwellings
/NEW EW ALT. D AD'N. D RPL. D MVE. I 4- 1
7, OF ❑ OTHER
WORK ❑ BLD. D PLMB. 0 MECH. M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not q'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) T-
8-
FEES COLLECTED
8.a i r�1 CA,l.£ �1 t PE C O cc,c D>)
VALUATION SOURCE GAS ELECTRIC WATER SEWER
Ownership SE CODE
. 510
+ciQQ UTILOITIFES "rk(r Public El Private 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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
to give authority to violate or cancel the provisions of any other state or local law regulating constructi°f or the
performance of construction.SEE -EV RSE SIDE FOR REQUIRED INSPECTIONS / . Plumbing
DATE OF APPLICATIO 0171 SIGNATURE OF APPLICANTh'A . !LOA. r Lll Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
it-
NAME DATE Plan Check
Env. Health �,�
ND7 f ) }RCTPLA e?k,tT1"VCS $AornE -DpovvP,4 O ' jGtr SEPA
2
Planning CD
J�
r.,.)Fire Marshall Mobile HomeD•�7C� _J
ii
Co. Engineer Other (Specify)
U O—C (2..S Gtc+D
Utilities
TOTAL $S'D •CO
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
ui 'ng Technician PERMIT IS NONTRANSFERABLE 1'.0 ;,-x`0I'-8 2 9 0 G,6 z *5 a 0 0 °a-� -
�h 7 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL