1982, 10-12 Permit G82A 9182 BoilerPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
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PERMIT NUMBER
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3.
4.
6.
JOB ADDRESS
LOT
BLOCK
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
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SUBDIVISION
ADDRESS AN nn
CONTRA
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ADDRESS ?cam-, i
DESIGNER
ADDRESS
TYPE
7. OF
WO RK
9.
P ONE-4)4S
PHONE
L'1 ALI. ,❑��AD'N. ❑ RPL. ❑ MVE.
0 BLD. 0 PLMB. L ‹CH. ❑ M.H. ❑ POOL
VALUATION SOURCE GAS_
OF
UTILITIES
ELECTRIC
❑ OTHER
TER SEWER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
DYes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement Unfin. Basement
No. Baths No. Stories 1 No. Rooms INo. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. Location (Area)
Ownership
Public ❑ Private D
USE CODE
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 regulatl'ng construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO r\ -
DATE OF APPLICATION IC' (.0? 2_ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
{shoo
i100v 4 .
Req'd. Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. !'
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ (el
-
04* * 1 8.00
*18006
R *O,00
91812
10-06-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
is
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
to 06 82 918.25 *18,0:0d17-1
DATE ISSUED PERMIT NO. TOTAL
t