1982, 09-01 Permit: 82A-7697 Repair Fire Damage PLAN NUMBER PERMIT NUMBER
APPLICATION/PERMIT P�`A ---kact7
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
VNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS – * 2-: * * 7 C' 0 0
L..5- c5-7 1 ��, LEGArDESCRIPTION — SEE ATTACHED * 7 5 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * co0 +
2. -1 4 - ti,:..tr,..00Y.1 A.,-) 0 P.
OWNER PHONE
N�lifgts A Attc. ,P.vA LA.:...: ` . 44--3c,07 7 6 6
3 ADDRESS ZIP Actual Set Backs in Feet
� rTl� �r:` i(N�i
C._ `C jiff✓--) 1 ��"7f''C North ISouth East 'West 6 4 7 p
CONTRACTOR PHONE Size of Parcel Zone Classification
r(b(ZTf'+ c,:_v✓ '�✓ - , 4e3-4;0 4- '"'" i NG(,.. . r0.0/..,i�1
4.
ADDRESS ,c ,/� /ZIP 'T�yp7e Const. Occupancy Sprinklered
N^5?C S ill/1Qtiske— —l"1..�-CD 'h) to °"�`s Oyes ❑No ❑ Req'd.
DESIGNER PHONE Val ation Building Area in Sq. Ft.
5. jt —
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. __
TYPE �/ No.Baths No. Stories No. Rooms No. of Dwellings
❑ EW ❑ ALT. ❑ AD'N. tIQRPL. ❑ MVE. i
7, OF 0 OTHER Req'd. Recd. Not Req'd.
WORK LLLSSSfff BLD. 0 PLMB. ❑ MECH. 0 M.H. 0 POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK Enum.Dist. I Location (Area)
8. Ft ; --Demo." 6 , -C' a? 4a_ I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
�
j OF Public 0 Private 0
! UTILITIES
, Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included _
Building
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this 1 :6.oe"
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 1,/ IGNATURE OF APPLICANT (��OYL Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
0 C ".-2, `p. SEPA >-
a..
Planning p
U
Mobile Home LU
Fire Marshall --1
Co. Engineer Other (Specify)
Utilities
• TOTAL $ &-
Plans Examiner
p -- ' sem-A WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
ding Technician PERMIT IS NONTRANSFERABLE ' o *'7 5. 0 0
09 -A01='82 769.72
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
4 y