1982, 03-24 Permit: 82A-2139 DemolitionPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JQB AD S
1.
LOT
2.
3
OWN
DRES
CO 7 5
BLO K SUBDI ISION
4��
ADD
LEGAL DESCRIPTION — SEE ATTACHED
J -x'[-11-
RES: I' v e +11
PHONE
PARCEL NUMBER/S
CONTRACTOR
4. ADDRESS
PHONE
Actual Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
ZIP
Type Const. Occupancy
DESIGNER
5. ADDRESS
PHON E
Valuation
v
Upper Floors
ZIP
CHANGE OF USE FROM
6.
TO
Main Floor
ArArea1 of Decks
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ 5, W 0 ALT. 0 213LD. 0 PLMB. 0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
Ise -OTHER
❑ POOL.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Int ICE> 125►\A O l 110
VAL ATION SOURCE GAS ELECtRIC
OF
UTILITI ES
9.
Enum. Dist.
ILocation (Area)
WATER
SEWER
Ownership
Public ❑Private 0
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 REVEF3$E SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION'
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buf Techn n s
SIGNATURE OF APPLICANT G 4 -t
SPECIAL CONDITIONS:
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
$
PERMIT NU11516 R
flAiN
02*
A
2138
03-24-82
6479
*2000
* 2C:00
* 20006
*C00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'5r 24 8 2
DATE ISSUED
21402
*•2Q00a:.
PERMIT NO. TOTAL
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