1982, 02-26 Permit: 82-1312 MH PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
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
i.33�.7 iii-
LEGAL DESCRIPTION — SEE ATTACHED C: 7 * * 5 0 G 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 22...G4z ..-zi 1ILL x 5 0 0
2. PT of TEZ l'7( / N loo F-r op S ►Lo FT 3 0 U.
OWNER
PHONE o F tA.), i2
3. arEKN! H. S c' E
A LJ_.m(L. `1Z6 544-4 VF R v- of E 5-3G F T a S i 0 c e 1
Q
1
ADDR'ESS / ZIPActual Set Backs in Feet `
&DX 13551 .5phKANE c q ZI 3 North 1 Vt ISouthast 's' (West ( 7 9.
CONTRACTOR PHONE Size of Parcel Zone Classification
4 SAME- 100 1 X 12,9 ' Ac,E?ic:iAL-r“=A L.
ADDRESS ZIP Type Const. Occupancy Sprinklered eize0V-M R-3 ❑Yes ❑No ❑ Req'd. CT
DESIGNER PHONE V luationBuilding Area in Sq. Ft.
*7 S7
-T 5
5. ADDRESS ZIP Main'rF�� c0 Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. -- — — ''t' •0•%(:DI N GN
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE L-JNEW El A 0 AD'N. 0 VE. / /� y�
7. OF 0 OTHER 1 - ( ��Z ‘T
0 Req'd. Recd. Not F�eq'd.
WORK BLD. ❑ PLM ❑ MECH. H. ❑ OOL CERTIFICATE Req'd.
of EXEMPTION See
DESCRIBE WORK Enum. Dist. I Location (Area)
8. MOBIL Ho ME- S R ]VENC;, ( I X 4-$ FEES COLLECTED
VALUATION SOURCE GAS EL r-IC WAT R SEWER Ownership I USE CODE f.re
OF9. UTILITIES SellC. Public 0 Private lF}'/
Single $
I hereby certify that I have read and amined 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.SEEREVERSE SIDE FOR REQUIRED INSPECT! N Jai Plumbing
DATE OF APPLICATIONX r-!/L— 0 / i
SIGNATURE OF APPLICA N =Z �; Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: --...m,
NAME DATE Plan Check
Health
Pjl i O 61 J,-5/L" SEPA
Planning
t Ci O
5€ 12rv6,141-e VYLtOa_" L►4
WR-e-1}., 16 m511'
Fire Marshall Mobile Home J
LT.-
Co. Engineer Other (Specify)
. Pc& -y . /1 t/5i
UtilitiesGC
TOTAL $ 50_ X
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
', `• .
° J
Building Technician PERMIT IS NONTRANSFERABLE '0'Z � 6 -j82131.2 z *50.00a 1-t
-
gS#`1(61c le 0— PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
(1p -1/14 v_5J
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