1982, 01-18 Permit: 82A-356 Insert PLAN NUMBER APPLICATION/PERMIT
�yy� PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT /'�' S `�
4.1 NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS t.i:ii 7 TO MAKE 3 COPIES
JOB ADDRESS
1. TG/gOri 6 . k tcfm ` , eiG X� LEGAL DESCRIPTION — SEE ATTACHED [ * ( t
LOT BLOCK SU DIVISION- 1 W I PARCEL NUMBER/S
2.
OWNER PHONE
3. t * G L. f, U
1 A\ & �C'A Q\k cia�S'to�Scia� �1
ADDRRREE,S`S N;y ZIP Actual Set Backs in Feet
(ATRACT� ' �1 1\Q I PHONE
H LONEC�QL, Size NorthoParcel !Suth Ea
Classification
st 3 5 '3
4. ADDRESS ZIP Type Const. Occupancy Sprinklered b. G- `l r
Oyes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. 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
Ei NEW 0 ALT. 0 /D'N. 0 RPL. 0 MVE.
7, OFOTHER
WORK 0 BLD. 0 PLMB. YMECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum.Dist. I Location (Area) r FEES COLLECTED
8- 'SNOv V'fN�e C '. I
VALUATION SOURCE GAS ELECTRIC WATER SEWER
Ownership USE CODE
OF
9. UTILITIES Public 0 Private ❑ 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 Building
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 ' / Plumbing
DATE OF APPLICATION //I td, /8' SIGNATURE OF APPLICAN �� =-/ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA o
Planning C
_ c
Fire Marshall Mobile Home u
u
Co. Engineer Other(Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
qui 1=nT05ch PERMIT IS NONTRANSFERABLE8 -8'2 .3,5,6 Z *2 O.0 0 a e' -
01 -1
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL