1982, 12-14 Permit: M82B-1878 Mechanical FixturesPLAN NUMBER APDL SCAT or" a /PERMIT PERMIT MBF &-7(
SPOKANE COUNTY — DEPAk:M' ENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. ast 11115 - 24th.
LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER
PHONE
PHONE
?aul Kru-,ja.
928-2745
3
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
Last 11115 — 24th.
95206
North South East
West
CONTRACTOR
7Talle
LICE SE�EXPIRES
/1
P1i NE
2-..790
Size of Parcel
one Classification
1
Residential Elr
r irepla.ee, Inc.
1 83
Commercial C
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
1.6610 Sara ue Ive.
❑Yes ❑No ❑Req'd.
DESIGNER Veradile, 'vra.
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE 11 NEW El ALT.
C1RPL. F1MVE.WORK
7. ��'N.
❑ OTHER
_T
❑BLD. El PLMB. MECH. 1-1 M.H. El POOL
Cyrtifi.ofExempt.
Required
Yes No❑
Number
or Variance
Received
Yes El Noll
aZe iIT6 lscr , !3erl-al
" a Yi
DESCRIBE WORK n"'
Shorelines/ Flood Hazard
Plans Required El3.
`=�iFF-402
Yes ❑ Not Applic. ElReceived
E
VALUATION
I
I SOOUFCE
GAS
ELECTRIC
PUB IC 1-1SEWATER
PTIC ❑
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public LJ Private ❑
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this ty
work will be complied with whether specified herein or not. The granting of a permit does not presume to givBuilding
thority to violate or cancel the provisions of any other state or local law regulating construction or the performof
construction. SEE REVER E S FOR REQUIRED SPECTIONS
Plumbing
SIGNATURE OF - APPLICATIONOWNER
OR AGENT DATE __...___Mech.
e -t
SPECIAL APPROVALS SPECIAL CONblTIONS: (SEE R1 VERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Techmg I�IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
L.� ITOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DAT"l Ea 4-8 ) PERMITI0.7. 8 Z
*20.00RCOAL
CL
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V
W
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