1982, 04-14 Permit 82A-2837 MHPLAN NUMBER
•APfLICATION/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 BLOCK SUBDI ISION
\� � F. rv�c.tz.ca=-r
2.j
OWNER
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NU MBER/S
1
Cpcts4' -c -
ADDRESS
j 4Zc i1i11=kiJ.`iFl�L
ZIP
—0r.
CONTRACTOR PHONE
' ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
NEW
❑ BLD.
❑ ALT.
O PLMB.
O AD'N.
O MECH.
DESCRIBE WORK
8. W t IJ� ►�/id c3:1 C
VALUATION
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
SOURCE
OF
UTILITIES
GAS
❑,RPL.
M.H.
vvtF
ELECTRIC
PHONE
O MVE.
O POOL
0 OTHER
(/'X 7o)
WATER SEWER
North
Actual Set Backs in Feet at`- T (0c
(South East
West
Size of Parcel Zone Classification
Type Const.
Valuation
b��
Main Floor Upper Floors
Area of Decks
No. Baths
_ j
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area Storage
Finished Basement
Unfin. Basement
No. Stories No. Rooms No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum, Dist. 1 Location (Area)
Ownership
Public ❑ Private
Req'd.
USE CODE
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Rec'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
07* *50.00
* 50.00
* 50.006
*0.00
283.E
04-14-82
g 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ping chnici n
PERMIT IS NONTRANSFERABLE
04-14•-82 283,75 *50,002r2 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL