1982, 04-28 Permit: 82A-3381 AdditionPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
V APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1 JOB ADDRESS 3S� LEGAL DESCRIPTION — SEE ATTACHED
LOT I B OCK 5 BDIVISION PARCEL NUMBER/S >3S44 7 2-00
OWNER
PHONE
q2Y-59-70
3.
ADDRESS
ZIP
Actual SPPe�t� Backs in Feet
6
North W2. South 3CX
East 23 lWest
CONTRACTOR
PHONE
Size of Parcel
1 Ll (o x q S
Zone Classification
_ 1
4.
ADDRESS
ZIP
Type Copst.
I9-3
ered
kl❑
VP
JancY l i
,IVAAI
❑Yes ❑No Req'd.
DESIGNER
PHONE
Valuation
BuildinArea in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor
Upper FloorsGarage
Area
Storage
CHANGE OF USE FROMTO
Area of Decks
Finished Basement
Unfin- Basement
6.
—
._—
TYPE
No. Baths
No. Stories
No. Rooms
No. of Dwellings
❑ALT. AD'N. ❑ RPL. ❑ MVE.
17,
OF
❑OTHERWORK 2,/N
1
B'!D. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Reqs!
of EXEMPTION
DESCRIBE WORK
-TC) ,
Enum. Dist. I Loc t' (Area)
FEES COLLECTED
8
VALUATION
SOURCE
GAS
ELECTRIC
WATER
CODE9UTILOITIES
I
��10vvnershipUSE
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
Building2i�
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
4
Mech.
DATE OF APPLICATION
SIGNATURE OF APPLICANT 0-Y1L-
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. alth
��0-,o y -V(�-� ��Y./�1^ri'\.. /�"✓\ llt7 1-1
SEPA
PI nnmg
Fire Marshall
Co. Engineer
Utilities
AA
clans Ex i r
SEPA C ck t
Quildi Technician PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
PERMI"i NUMBER
Mobile Home
Other (Specify)
W1WHETOTAL $01—
WHEN
N MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0='8 2 3*M.125
DATE ISSUED PERMIT NO.
*61.0.0 �
TOTAL
ccs
-3/3-, -=/�r 1--I07` /4Xz/�
r