1982, 09-29 Permit: 82A-8839 Special Inspect PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT SQA - 5!q
el
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 1 1 * * 8 0 0
l„��, -=..--2-,4C) LEGAL DESCRIPTION - SEE ATTACHED
* ? 00%
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. Fi C ., '
OWNER PHONE
3. C.S4VhcrezNi La-:t'�C. 4sj(n •C,1C°t« 8838
ADDRESS ZIP Actual Set Backs in Feet ,-,— G _ L
U.) , —n- - �j,V
- � .(
E `) Q61 North !South East IWest
8
CONTRACTOR PHONE Size of Parcel Zone Classification 6 (( '7 9
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
Dyes ❑No ❑ 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
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF OTHER Req'd. Recd. Not Req'd.
WORK
ID BLD. LI PLMB. ❑ MECH. 0 M.H. El POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK Enum.Dist. I Location (Area) '
FEES COLLECTED
8. _ Et-i.4.6. .,. %t' i7 `c:-i"c iCI to -- �I t- 'm( I
VALUATIONI SOURCE GAS ELECTRIC I WATER SEWER Ownership USE CODE
OF Public 0 Private ❑
9. UTILITIESSingle $
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 the
performance of construction.11SEEnREVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION ? d f 8-2.___ SIGNATURE OF APPLICANT , Mech.
SPECIAL APPROVALS SP CIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA 2
r,>
Planning ,
— iu
Fire Marshall Mobile Home( A
Co. Engineer Other(Specityl
Utilities
TOTAL $ - ^)
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
-19, 01 ec ician PERMIT IS NONTRANSFERABLE9.6-12
t it 4, I o * 8.0 o J —
� �^�' 0�9.�Z4 -8 2 8 8 3.9 Z 0 a
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL