1982, 04-07 Permit App 82A-2586PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — Et1'i31ING CODES DEPARTMENT
YtKNI I I IN UIVII]CK
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
2.
JOB ADDRESS
. I7104' I dIAN] f cLOT
OWNER
3. r-r I
ADDESS
BLOCK
4.
CONT T 21.7
• 11
ADDRESS
SUBDIVIS
eitielt9s60 prcT pt-f l't
HONE
cHOR
o11
HONE
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S D7 554 — I U 3
(,J I/2_ I/2- cf `�I� • .z- Cn
Actual Set B cks in Feet
North 'South
East
(West I
Size of Parcel ittk., (Zone Classification
Typg Cpnst.
Occupancy
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.
TYPE
7. OF
WORK
8.
9.
TO
CJ NEW ❑ ALT. ❑ AD'N_ ❑ qPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH. iJ M.H. ❑ POOL
DESCRIBE WORK
IlI j- 1
VALATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
/ LX 7a
0 OTHER
SEWER
Area of Decks
No. Baths
Finished Basement
No. Stories
No. Rooms
Unfin. Basement
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private 127
USE CODE
Req'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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 3 a " SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Fnti Healt
•�r' in
olf/I0 4a/7?
re Marshall
SPECIAL CONDITIONS:
2 (1—38- ?
Lkhl-
Plans Examiner
SEPA Checklist
Building Tec ci n
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home ✓°
Other (Specify)
TOTAL
$
07* *5C.00
* 5000
* 50006
*C00
04-07''-82
647c
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
tr
04rt±Q7-82
258.6z *50.00 _
c
C
DATE ISSUED
PERMIT NO. TOTAL
14,
/ 5 0