1982, 11-15 Permit: 82B-0947 Pole Bldg PLAN NUMBER
APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDIP;,G CODES DEPARTMENT .7--.f.) -
@." NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. E.►i'7i0 l5-1 r" LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 0 2 * * 1 6 8 0 0
2.4. 05 3 'I N OPP®C2Lx-vvtTIAE�c.E-t-c� * 1 6 8 0 0
OWNER PHONE
�Cc.v � �tr� �� G2.C., --2,4-5'3 TM Zt544'."- 16'1443 A * Q 2
3 ADDRESS ZIP Actual Set Backs in Feetn
'. 'M 7 2 1 ._
iU . ".J 1`3 C'�!7-cuGi e{N �.� -1 North 32 'South East n' (west 1 1
CONTRACTOR PHONE Size of Parcel Zone Classification - 0 a`8 2
pi .--6 u 1,t✓�cK-rz...c_.-r+x cid-14 A- i Rc2cC,t t t . ` ,tv e,,Le =ww4..�t_"--( 2 6. 4 %9,
4. ADDRESS �ZIP� Type Const. Occupancy Sprinklered
N•g-J3►s C tZCZ.G:,p: - -s"t'-'t er"c,Z -a 1h.1 T2._- )0,-1 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Val ion 4 Building Area in Sq. Ft.
5.
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
i"2cc.,
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. Z5(? `3-ts-
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ ❑ MVZ C
i� ❑ ❑NEW ALT. AD'N. RPL. E. ' .. i
], OF J ❑ OTHER CERTIFICATE Req'd. Rec'd. Not Rpq'd.
WORK L"J BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL i/
of EXEMPTION _
DESCRIBE WORK Enum. Dist. I Location (Area)
8. ?p.c. .- ettL.T -ct2..�cTt,tliF 4-+(133..a�rvk".-1-cFEES COLLECTED
I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership / USE CODE
OF
t..
9. UTILITIES C ?2.G Public 0 Private L!
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 .
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or t e
performance of construction.SE RE -ERSE SIDE FOR REQUIRED INSPECTIONS ' Plumbing
DATE OF APPLICATION 4. HSIGNATURE OF APPLICANT A k; Imo/ 1— Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: ] `iov t_c' w Plan Check
NAME DATE
�� ' <
Env. Health
te kpl 41;Z SEPA 2
Planning CD
— w
Mobile Home —A
Fire Marshall
LT.
Co. Engineer Other (Specify)1®0.6°
`'-;77(1.;"nP 1/
Utilities 1�0�
/ TOTAL $
Plans •
F,xamm,or / /
it) /a l'.. 2 z� WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
'
Building Technician PERMIT IS NONTRANSFERABLE 1'1 S' -8 2 9 4 7 °z *1 6 8.0 0 a F_
�r � C 2t:"10 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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