1982, 06-01 Permit 82A-3567 Green HousePLAN NUMBER
52/9— V
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 BLOCK SUBDIVISION
2 e rec -a__I i"'r`T
OWNER
3 0 "r 6 - (C
ADDRESS
COINTTRPc qg
4' ADDRESS
RoA101.4
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
TO
BL❑ W ❑ ALT. G AD N. ❑ RPL. ❑ MVE.
D. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
8.
VALATION SOURCE GAS E1_ECTRRIC
OF
9. UTILITIES
WATER
0 OTHER
SEWER
�f+
LEGAL DESCRIPTION — SEE ATTACHED
Actual Set Backs in Feet
North South East
Size of Parcel Zo e Classification
TypeLCbnst. OYcupancy Sprinklered
�V vp � ❑Yes ❑No ❑ Req'd.
Valuati.n ry 0
Main Floor
Upper Floors
No. B. s No. Stories
CERTIFICATE
of EXEMPTION
Building Area in Sq. Ft.
Garage Area
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private
SE 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
SPECIAL APPROVALS
NAME DATE
Env. alth
Pla ning
7
Fire Marshall
Co. Engineer
Utilities
f2i- /aC: d'4ay
Plans Examiner
SEPA Checklist
(9,2 OF APPLICAN
SPECIAL CONDITIONS:
Storage
Unfin. Basement
No. Rooms No. of Dwellings
Req'd. Rec'd.
Not 5t€q
FEES COLLECTED
Single $
Building
Plumbing
,a M�eh.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ter/
PERMIT NUMBER_
� 5 lT� r f/y�
7
0.2* *2E00
*2E00
*2E00�
A *o.00
301,6 0
04-21 —82
6. 7 9
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• "ng Tec -
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
d.54�f-82
tr
35.6,7,Z
DATE ISSUED PERMIT NO.
*28.O;Oa�. -
TOTAL