1982, 05-28 Permit: 82A-4339 StoragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILUHIG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
• i
LOT
2.10-1
Z
1.
BLOCK
tG 'JEt•i\lw
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
b`�a127cu.
CP fu 3c —O
OWNER
3. a •
ADDRESS
CONTRACTOR
ADDRESS
�r+vKlc.
DESIGNER
4,
5.
PHONE
PARCEL NUMBER/S
2?szi. 2- is Act
ZIP
aq
Actual Set Backs in Feet
North 1r (South
East 1West
PHONE
Size of Parcel
141 h 13(0 Ae.coc
Zone Classification
� Z
ZIP
Type
Const.
Occupancy
�A
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Val tion
3, 012
Building Area in Sq. Ft.
x768
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
kr /NEW 0 ALT.
qd BLD. 0 PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No: of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not R d.
DESCRIBE WORK
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
ISCP"rt.C.
Enum, Dist.
Ownership
Public 0 Private
Location (Area)
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 construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATIONf ? SIGNATURE OF APPLICAN
I
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
freitr
SEPA C ecklist
Building Tej74ifain
PERMIT IS NONTRANSFERABLE
ncORA IT sr of O re llKIC VC A D CDl111A rIA TC AC MCI 1 A NIPC
FEES COLLECTED
Single $
Building .54. Oa
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ `C°
PERMIT ivUMBEk
2A--- S 3?
14 33,
511 C 0
t. /1 7
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Q` 5, 2 & *;g 2.
fATC ICCI ICf\
43'A'.92 *54.Q11a_
DCORAIT AI(1 T/lTA I
- 1 v D 1 -, '�. a7 Qi
0 l Po re, n / T y 7- c s-,_ Q cir , f , o -�
cors to .`47t ll --a_ L
t, s 7 P 00/0.7