1984, 02-10 Permit: 84A-1151 ResidencePLAN NUMBER APPLICMION/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 ADDRES
7 -To LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDI ISION PARCEL NUMBER/S
z. see ae� ow 33 5?
OWNER PHONE
3 ADDRE0'1
ZIP Actual Set Backs in Feet r
North r South East West ��
CONT ACTOR PHO
SPECIAL APPROVALS
NAME DATE
v. Health
4
eklarthall
J.Co. ngi r
UtilitYes
Plans amine►
{
SPECIAL CONDITIONS:
o'P LCA- 94) Bloch 33 Koko mo ` cO-dns 3c'p-
Gal lilt k t L- iG_ y Z- Z& j
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
OL,
TOTAL $
PERMIT NUMBER
e / 1 1 11�;l
7
00
yf
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
02 130-8:4" 115,`112 *366.00°-J,
DATE ISSUED PERMIT NO. TOTAL
1
NE
llla. as 39 oll
Size of Parc I i
Zone Classification
13
DIRE
ZIP
_7
Type/Co st.
Occupancy
Sprinklered
V
❑Yes [-]No ❑ Req'd.
DESIGNER �p
5. �r
PHONE
Valuation
,`fin`}
Building Area in Sq. Ft.
ADDRESS
ZIP
Main F oor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
s.
TO
Ar� f Dec
Finished Basement
U[tfin. Basement
k
Iz d o
TYPE
NEW El ALT. El AD'N. 1:1 RPL. El MVE.
No. Baths
ho. Stories
No. Rooms
No. of Dwellings
7• OF �❑ OTHER
D4 El WORK BLD. PLMB. MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.Not
Req'd.
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
8•Ape GAO,
FEES COLLECTED
I
VAL TION SOURCE
GAS
ELECTRIC WATER
SEWER
Ownership
USE CODE
UTILITIES
W
5r-�1C
Public ❑Private
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
Single $
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. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
c �
/
/
DATE OF APPLICATION['3 SIGNATURE OF APPLICANT
Mech.
SPECIAL APPROVALS
NAME DATE
v. Health
4
eklarthall
J.Co. ngi r
UtilitYes
Plans amine►
{
SPECIAL CONDITIONS:
o'P LCA- 94) Bloch 33 Koko mo ` cO-dns 3c'p-
Gal lilt k t L- iG_ y Z- Z& j
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
OL,
TOTAL $
PERMIT NUMBER
e / 1 1 11�;l
7
00
yf
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
02 130-8:4" 115,`112 *366.00°-J,
DATE ISSUED PERMIT NO. TOTAL
i
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