1982, 05-03 Permit: 82A-3435 AddiitonPLAN 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
JOB ADDRESS
LOT
2..34-"5
BLOCK SUBDIVISION
�LJI r tQ . b REf t. &-CC'.)
3
OWNER
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
E. '7
4.
CONTRACTOR
vv'l�
ADDRESS
��l�Yv�r✓
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
ZIP
Gtr c7G
PHONE
ZIP
PHONE
ZIP
TO
,Mi/NEW ❑ ALT. 'AD'N.
L'7 BLD. ❑ PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
0 POOL
❑ OTHER
Actual Set Backs in Feet
North 'South 4.°'
East �E' 'West
Size of Parcel Zone Classification
x 17.-."1
Type Const. Occupancy
ary
Vliyattiion
i��ycof-7.,e)
Main Floor
`29.-z7)
Upper Floors
Area of Decks
No. Baths
' R .
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
;), p c•)
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Storage
Unfin. Basement
No. Rooms
Req'd.
DESCRIBE WORK
8. 40-D
rTcvrJ Tv ��GDE ucE
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
Enum. Dist.
Location
(Area)
SEWER
41�IIL
Ownership /USE CODE
Public ❑ Private
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 doe not presume
to give authority to violate or cancel the provisions of any other state or local law regulating coistr ‘ction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS/
SIGNATURE OF APPLICAN morAPY4 , /
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env
tee/
Planning
Fire Marshall
Co. Engineer
Utilities
P ns aminer
E A ecklist
Bujlciing Te nician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd.
of Req'd.
FEES COLLECTED
Single $
Building 0-75,av
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ° CO
PERtG1IT NUMBER
Siz —3 1--3`•-,'
0.2* *7500
*`7500
*75.006
A X0.00 S
343,32
05-03-8'2
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
n.
0 7q }. 8 2 343,5.2
*75.0O21 --
DATE ISSUED PERMIT NO. TOTAL
04
t
4LL5y
1
L