1982, 09-13 Permit: 82A-8149 MH PLAN NUMBER APPLICATION/PERMIT PERM' MBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
/'y/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
(�/� APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
" .. • c C U U
JOB ADDRESS .SOL LEGAL DESCRIPTION — SEE ATTACHED - 2 r
LOT BLOCK SUBDIVISI N `/t , ' PARCEL NUMBER/S /� :c_2 _As 7
•
OW /R_ n 1 PHONE r��f %Cl-t- I / `2 _ (; (-Ji J aJ
-/�4 -ve., iii /p i"- 4•c/T / "v-� •
3 A) /D�RESS7 r / ZI Actual Set Backs in Feet (J — I `'G
/ / 9oc O C. ��C�-- 79..0/‘ / North /j, 'South i, East 6 'West 2 �4 -= 7 C
�NTRACTOR PH .2..Z .b Size ofParcel
A0 ZonPC`:aAsifipation
4' AD RxtESS r.
/Z�7y� TT'lyppeefr-�1CConst. Occupancy P.
v`S+Cpprllinklered
DESIGNER/ Fe
� ! / roiONE nation //ii Ni Building❑ s0Neaon S❑q. Ft.
5. I Cl — Z
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage -
- ..,.
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin, Basement
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE
KNEW 0 ALT. ❑ AD'N. 0 RPL. 0 MVE. 1 / /
7. OF 0 OTHER —
WORK Ar BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Dist. I Location (Area)
8 i j` 4:! .. )4,19 ..-3
/ FEES COLLECTED
VALUATION SOURC GAS ELECTRIC WATER SEWER Ownership USE CODE
OF Public 0 Private,�l
9. UTILITIES 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 construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECT Qpl. Plumbing
DATE OF APPLICATION 7"" / SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS I SPECIAL CONDITIONS:
NAME DATE Plan Check
Env, ealth7/A3
SEPA
Plannin
U
!.tl
Fire Marshall Mobile Home --J
Co. Engineer Other (Specify)
Utilitiesfea
TOTAL $ "''E-)
Planer ��� ,
�L 'V i lit WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
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Buy ec,ly _SZ PERMIT IS NONTRANSFERABLE 0'9.1`3' 8 2 8 1 4;9 °z * 2'8.0 0 a F -
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CIN----- PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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