1982, 06-21 Permit: 82A-5174 Inspect FeePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKi1l."E, JV.;,3HINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB DRESS
1.
i X10 .3 7 � LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK 15UBDIV15ION PARCEL NUMBER/S
2.
OWNER /ten ((,—K— Q
3.
ADDRESS� I
�
��
Actual Set Backs in Feet
*;-- 12229v N
I
�
North South East
West
CONTRACTOR
PHONE
Size of Parcel Zone Classification
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Dyes [-]No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Ar;T
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
��
No. Baths
No. Stories
No. Rooms
No. of Dwellin
TYPE MVE.
LJ NEW ❑ ALT. 11AD'N. ❑ RPL. ❑OF
7 j�(/�
El BLD. 13PLMB. 1-1 MECH. ElM.H. 11 POOL — -THER
CERTIFICATE
Req'd.
Recd.
Not Req'
WORK
of EXEMPTION
I
DESCRIBE WORKEnum.
8 '� , I
1
Dist. I
Location (Area)
FEES COLLECTED
VALUATION
SOURCE
GAS
ELEC IC
WA R
SEWER
Ownership
USE CODE
9.
OF
I UTILITIES
Public El Private ❑
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
U�
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
^
— `
Mech.
DATE OF APPLICATION
SIGNATURE OF APPLICANT �i
SPECIAL APPROVALS
NAME DATE
iv. Health
Planning
Fire Marshall
Co. Engineer
SPECIAL CONDITIONS:
ns Examiner IL
nicia PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
t70
TOTAL $
PERMI'i NUMBER
02* *F00
*F0010
A *G00
51 7.3
06-21-82
6 4 7 Q
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'6-2x--82 517Az
DATE ISSUED PERMIT NO.
*8.00a�
TOTAL
P.