1982, 01-11 Permit: 82A-200 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
r 8,2A -2oo
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 "no n 4- * * G (' n 0
LEGAL DESCRIPTION — SEE ATTACHED
1. E.,. 1117 i4- l 6'1-'4 * i; :' ;'
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. * LC is V c
OWNER PHONE
3. ALL.€-3 L AfLG1.t✓A:i 4 Zl-1$i 3 r', * t.. ., _.
ADDRESS ZIP Actual Set Backs in Feet i C 9 -_
G • 11Q14- t(0TN Gel? .. North 'South East 'West
CONTRACTOR� PHONE Size of Parcel
I� Zone Classification — 1 1 —3 c
-'� VYIE
4' ADDRESS ZIP Type Const. Occupancy Sprinklered 67 �'
' 40/4Yv,t6 ❑Yes ❑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.
TYPE �/ No. Baths No. Stories No. Rooms No. of Dwellings
B/NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF �/ ❑ OTHER
WORK
0 BLD. 0 PLMB. Li.J MECH. 0 M.H. ElPOOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
8 Zw J e..1.— Aire..."
.L + NJ( Frf f G J I FEES COLLECTED
VALUATION SOURCE GAS I ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private 0
..- 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 constru' i n or the '
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTION j/ �� Plumbing
�j Zo.vo
DATE OF APPLICATION /'`1 .—ez SIGNATURE OF APPLICAN or. ,
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA >-
Planning O
C.>
Fire Marshall Mobile Home 1..0
_i
Cr._
Co. Engineer ' Other(Specify)
Utilities
TOTAL $ 20.O0
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician PERMIT IS NONTRANSFERABLE 01..,.. i;
1 '-'8 2r '2 0.0 2 *2 Q 0 0 a F
W‘acif,_,Isiliy., PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL