1982, 10-12 Permit 82A-7863 Soffit, FasciaPLAN NUMBER
PERMIT NUMBER
cJC.� , 7 G bO
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT B OCK
IT
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•
OWNE
3. F�I'l(� >I )e.hlrPn
ADDRESS
E . VI aD,
CONTRACTOR
G J (.�4 / Bin 1
4' ADDRESS
lit. •A 12 (r.
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
PHONE
ra g-4%4
ZIP
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PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/5
Actual Set Backs in Feet
North South
East
West
Size of Parcel
Type Const.
Valuation
Main Floor
Occupancy
Zone Classification
Sprinklered
Des ❑No D Req'd.
Building Area in Sq. Ft.
Upper Floors
Garage Area
Storage
TO Area of Decks
TYPE
7. OF
WORK
❑ NEW 0 ALT. 0 AD'N. ❑ RPL. 0 MVE.
❑ BLD. ❑ PLMB. 0 MECH. 0 M.H. ❑ POOL
DESCRIBE WORK
J 0.1
VALU 10 SOURCE GAS
OF
9. 1 UTILITIES
ELECTRIC WATER
$_OTHER
epat
SEWER
No. Baths
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Unfln. Basement
No. Rooms
No. of Dwellings
Location (Area)
Ownership
Public ❑ Private ❑
Req'tl. Rec'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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
5 2- SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Not Req'd.
FEES COLLECTED
2 Single $ O�
✓�
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
b0
TOTAL $ 3(0 •--
02* *3600
*36006
A *0.00
7862 i
09-07-82
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Build ici, n
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
o i'9,1:'e .7.'718"2
DATE ISSUED
786,3-
PERMIT NO.
*3 6.100(lip