1982, 12-10 Permit: 82B-1800 InsertPLAN NUMBER
APPLIC. BION/PE
PERMIT NUMBER
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 ADDRESS
r .�� T'I,—
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
PARCEL NUMBER/S
2.
I
ISUBDIVISION
OWNER
_rA lU
'1 �,� i t �+t d
3. C
PHONE
Q'
ADD ESS
zi P ,, /
Actual Set Backs in Feet
Y
North South East West
CONTRACTOR
PHONE �-
Size of Parcel
Zone Classification
err
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes []No
hof`
c.r .
DESIGNER
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5. ADDRESS
ZIP
Main Floor
I Upper Floors
Garage Area
Storage
*?CC�Oti
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPENo.
Baths
No. Stories
I No. Rooms
No. of Dwellings
❑ NEW ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF �/ ❑ OTHER
❑ BLD. ❑ PLMB. Z MECH. ❑ M.H. ❑ POOL
l L 2
L
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist. Location (Area)
FEES COLLECTED
8. L( CFL.L � / i�, rt; I -PL—
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
Q, UTILOITIES Public ❑Private ❑
I Single $
1 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 INSPECTI NS Plumbing
01
Mech.
DATE OF APPLICATION SIGNATURE OF APPLICANT ••- -
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ Z-0�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,f
a—B 2 ]N8 0.`0 z
DATE ISSUED PERMIT O.
* 2 0'-14a4�t —