1982, 04-05 Permit: 82A-2473 Pole Bldg PLAN NUMB, , APPLICATION/PERMIT PERMIT NUMBERSPOKANE COUNTY - BUILDING CODES DEPARTMENT 02A243
G NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS ' LEGAL DESCRIPTION — SEE ATTACHED 0 2 * * 3 8, Q Q
LOT BLOCK SUBDIVISIONj ' t �, /PARCEL NUMBER/S ,� 3, j_ 0 0 t,3
2. 3 i?, C�j�G'�.�1-n. Gly ,D2'Lfi,,eic/LL_2� C..', ,'�L3.+C�.�C.�
3. O W(R PHO3 `�f�LLc t , �Nq.�/f7s <705 5 g " 004/V A * 8� Q Q
�lhe 6 ) 0
ADDRE S ZIP Actual SetBacks in Feet
1,4"s-,2--1 North I/5 'South 67.6East S 40 IWest Q 2 £ 7.2 !
CONTRACTOR PHONE Size of Pa el Zone Classification
( f / z / , /4iX .6 A.cti42kC.A..,..-c�R 04-05-82
4. IP l &,( (53 (�f -1iye�w4t 4l7e,;- / •Type
„3P"�Const. Occupancy Oyes ❑No Sprinkl❑ Req'd. 4 7 9,
DESIGNER PHONE Vabaattion „` Building Area in Sq. Ft.
5. 11E34v '5/60
ADDRESS ZIP Main Floor Upper Floors Garage Area S/Drage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. `^' ,i... (...--
No.
�No. Baths No. Stories No. Rooms No. of Dwellings
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. . /
IS '�
ED7, OF OTHER
WO RK ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION LI .
DESCRIBE WORK / Enum.Dist. I Location (Area) t
8. pLC , LU L' . /1) /S 446 6O)(Ma� I FEES COLLECTED
/s VALUATION�� SOURCE GAS ELECTRIC (WWATER SEWER Ownership E9.1/ USE CODE
yn 16�nc.) OF
LLITIES t;C. Public D Private L9/ Sin9 le $
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 Building 00
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 construct�io�n�.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
Plumbing
DATE OF APPLICATIOd — u SIGNATURE OF APPLICANT / �sCl'' di", Mech.
N���
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE Plan Check
Env th
1/ SEPA
Planning
()
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities )
TOTAL $
Plans Examiner
)'s --2,'E,G.11:› WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
A
.11.....-ng nicia /1 _�_� PERMIT IS NONTRANSFERABLE (-I� k g * 8,
gl s !� 0'4 •..x} 5'—`82 247, 32 3 00 2 E. -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
COOK BROTHERS CONTRACTING JOB
Route 2 Box 853 B r, r-- l-1`,�= T) i 5 _ ems_
OTIS ORCHARDS, WA 99027 ,_.y�
(509) 924-1557 �°-°Y �1 2_621)(16 _i7.14.:' 0Aie=_____
CHECKED BY DATE ---
NSCALE
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FORM 204 Available from(A.L8S/INC Townse,d,Mass 01470
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