1982, 10-13 Permit M82-9462 InsertPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
-44/
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
JOB ADDRESS
y3/�
LOT
BLOCK
y • LTS
SUBDIVISION
L. "7
OWNER
3 ,-.72)lVAl ‘•9if/h.4AJ
ADDRESS
..7 • �3/ L ��t r 6 CjT
CONTRACTOR
4LtJCS7,E'.P ,� t 7 ..E4'/h A L. V' r.�iyl s
ADDRESS
`-*• .2.3 /S— V /S! O A.
PHONE
ZIP
PHONE
/d.g-/o/
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
Size of Parcel
Type Const.
Occupancy
East
'West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT. ❑ AD N.
❑ PLMB. 42-/�IECH.
❑ RPL. ❑ MVE.
❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
Enum. Dist.
Location (Area)
VALUATION
9. 1 ° 0
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
/ a/8/ceo7
DATE OF APPLICATION
SIGNATURE OF APPLICANT'
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
i
I duE! , 1 c cne
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech. ��•�
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $cF.D•eb
04* *20.00
*20.00c
A *0,00 El
946.12
10-13-82
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1`i0 8.2
DATE ISSUED PERMIT NO. TOTAL
9'46,2 2
*20.002.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE