1982, 01-05 Permit: 82A-0061 ResidenceIPLAN'UMBER
';/,4 5 Lam/
APPLICATION/PERMIT
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 A
i
DRESS
r7 Ji\ -r'
LEGAL DESCRIPTION - SEE ATTACHED
2.
LOT
C(-)
OWNER
LOCK
SUBDIVISION
ji ADD' -11 or\,
3 c I` -t) k
AD RESS
4.
CONTRACTpR
`,.11\•1
ADDRESS
PARCEL NUMBER/S �7 4 I _ ^ is
PHONE
1::72—(1.-) 6
PHONE
Actual Set Backs in Feet
North 'South L,°
Size of Parcel
1.2D
East
West } .��
Zone Classification
rA t i t'i'
ZIP
Type const.
DESIGNER
5. ADDRESS
PHONE
I Occupanfl
I
Val�lation(�
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
ain Floor
IIS
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
7.
TYPE
OF
WORK
EW ❑ ALT.
LlEBLD. ❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
❑ OTHER
Area pfl ecks,�
Finished
Basement
Unfin. Basement
j Stories
No. Rooms
No, of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Recy'd.
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
GA
ELECTRIC
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private II.
USE CODE
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
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of con. SEE REVERSE SIDE FOR REQUIRED INSPECTI IINS n /'
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. ealt
Plannln
//5
Fire Marshall
Co. Engipger
Utilities
Pltps Examine
'��'
SEPA Checklist
g.„Techni
A
SIGNATURE OF APPLICA
SPECIAL CONDITIONS:
1
PERMIT IS NONTRANSFERABLE
DCDnAIT CVDIDCC !MUG VCAP CDf1RA fATC CIF 'SSI IAII F
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
r7
TOTAL
PERMIT NUMBER
C,
* 25100
* 25100
* 251,006
*c00
U
307.3
12-31-81
6,47�i
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0i�,95` 82
IlATC I C1 ICrr
U.1 *25100°f--
DCD�AIT nlC Tfl A I
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