1982, 12-10 Permit: 82B-1806 InsertPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
. i t 4-6z:X '
LOT BLOCK
2.
SUBDIVISION
OWNER
3. 'Rot'. "t3sn.) t c�
PHONE
PARCEL NO.
LEGAL DESCRIPTION:
MAILING ADDRESSZIP Actual Set Backs in Feet to:
1= • 4-.o A-(01- t* fir{%lam- North South
4.
CONTRACTOR
13a.C4 or mec+.0 r\PA.12.6,t c�
ADDRESS
LICENSE EXPIRES
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
PHONE
ZIP
PHONE
ZIP
TO
TYPE L NEW ❑ ALT. ❑ AD' N. 7 RPL. 0 MVE.
7. OF WORK ❑ BLD. ❑ PLMB.YZ(MECH. 0 M.H. 0 POOL ❑ OTHER
Size of Parcel
Type Const.
New Const. Valuation
Cover Deck
No. Baths
East
West
Zone Classification
Residential
Commercial =]
Sprinklered
❑Yes ❑No Req 'd.
Remodeled Valuation
Garage/Storage
Uncv. Deck
No. Floors
DE CRIBE WORK
8• ' OD "e)c-cRN+n)G INS 6vZ-r
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Total Bldg. Floor Area
G eenhouse
Fin. Basement
No. Fin. Rooms
Required Yes❑ No0
Received YesD Nof7
Shorelines/Flood Hazard
Yesr: Not Applic. C
Ownership
Public D Private ❑
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 type of
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority 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
OWNERORAGENT�,� DASIGNATURE OF TECATIOy i9 -10 -?1-
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Required E
Received F.
FEES COLLECTED
Building
Plumbing
Mech. 47n.�
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify) _
?1J.i-e)
TOTAL $
PERMIT NUMBER
B�PS- 't8c�
04* *2C00
180,52
12-10-82
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEIS UEc. 0 - 8 2
PERMI IN4. a 6 Z
*2QOO• AL