1982, 06-03 Permit: 82A-4479 Addition PLAN NUMBER
1APPLICATION/PERMIT PERMIT NUMBERSPOKANE COUNTY BUILDING CODES DEPARTMENT 447
C9NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS1. 17 LEGAL DESCRIPTION - SEE ATT
ACHED
LOT BLOCK SUI39Ipil .osclN 1I PARCEL NUMBER/S 220. - i-X ,3
2. 3MoUN
OWNER PHO4E
ADD ESSP Actual Set Backs in Feet -� `� 0 2 * * 5 4,0 0
O7� 9�� North (South East cam' (West * 5 4 0 0 c-
CONVIA TOR E Size of Parcel Zoe Classification
1'\ P 0 c)01\I , • � ' X03 1 1 L 6- * 54006
4' AD res ZJ.�_J ! Typ onst. Occupancy Sprinklered
V b I ' / t,�1,o � ❑Yes ❑No 0 Req'd. A * 0,0 0 0
DESIGNER PHONE ValuationBuilding Area in Sq. Ft. 4 (1 7 8 2
' -33 1
5' ADDRESS ZIP Ma'yneFloor Upper Floors Garage Area Storage 0 6—0 3 4-8 2 _
9
CHANGE OF USE FROM TO
Area of Decks Finished Basement Unfin. Basement G 6.4 7
6.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE
EW 0 ALT. fiAD'N. 0 RPL. 0 MVE. �
7, OF 0 OTHER CERTIFICATE Req'd. Rec'd. NotRe,$'d.
WORK
BLD0 PLMB. ❑ MECH. ❑ M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK Enum.Dist. I Location (Area) FEES COLLECTED
8. OW-'')� b I`�I(:�IJ
VVALUATION SOURCE GAS ELECTRIC WATER SEWS Ownership I
,USE CODE
OF
9. UTILITIES ✓ K--, Public ❑Private
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 construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS, Plumbing
r , l
DATE OF APPLICATION �' �� SIGNATURE OF APPLICANT '.0'. � ,A 0 ! — . Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: ( z.i
NAME DATE �, ..� -, i , - Plan Check
En ealth / v
it €e- 613 SEPA rte,
c. / C)
Planning C�
Mobile Home ""
J
Fire Marshall U-
Co. Engineer Other(Specify)
Utilities
TOTAL $
ans Exami e y
✓— WHEN MACHINE VALIDATED IN THIS SPACE,
SEP.A.Checklist THIS BECOMES A PERMIT.
uildin echn n - PERMIT IS NONTRANSFERABLE 0''6 413,3 ;a}2 4'•4 7,9 Z *5 4 0 0 a �,
� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
PI*
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