1982, 08-06 Permit: 82A-6863 Addition BarnPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — P.JILWNG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
3
4.
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
L�,y T
BLOCK
S By 15(O N G—i1
OWN��
•
ADDRESS 4-4
COV 1 ACTOR
ADDRESS��ilL��'
DESIGNER
5. ADDRESS
PHONE
ZIP
PHONE
ZIP
PARCEL NUMBER/S 32_15744_ Dori:2
Actual Set Backs in Feet
North 'South
Size of Parcel
I.2 7? 3O 1
East
!West CC-)
Z e lassslfication
Type fCst.
OccgAuppaancy Sprinklered
,I of r!
Dyes ❑No ❑ Req'd.
CHANGE OF USE FROM
6.
TO
Valuatigr
Main Floor
Building Area in Sq. Ft.
Upper Floors
Garage Area
Stora e
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
❑ N W ❑ ALT. L7 AD'N.
BLD. ❑ PLMB. ❑ MECH.
❑ RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
8 DESCRIBE WOR fr oo �o / 24 /0 rt,464-
VALUATION G S ELECTRIC SEWER
SOURCE
OF
9. (UTILITIES
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not R. q'd.
Enum. Dist. I Location (Area)
Ownership �USE CODE
Public 0 Private (d
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 authority to violate or cancel the provisions of any other state or local law gulating construct- n or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
-4 3 / S4IGNATURE OF APPLICANT
SPECIAL CONDITIONS:
DATE OF APPLICATION r
SPECIAL APPROVALS
NAME DATE
Env ealth
Planning
Fire Marshall
Co. Engineer
Utilities
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PERMIT HUMBER
� v
02* *47.00
*47.006
A *0.00
67892
08-04-82
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0$x'86-8,2 686.35 *47.00a�
DATE ISSUED
PERMIT NO. TOTAL
y
y
1.670.
4
tor( Z