1982, 01-14 Permit 82A-283 Fire Damage Repair(PLAN NUMBER
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
LEGAL DESCRIPTION - SEE ATTACHED
2.
3.
4.
BLOCK
LOT
OWNER
SUBDIVISION
ES r+
PHONE
PARCEL NUMBER/S ✓ 1Ciy
N."3-77.G.' f: :xc.t4S'
�54-1- i41
ADDRESS
E-
. ��7Cc�4UC� t 2c:f�Q; Jda�
CONTRACTOR
*NA
ADDRESS
ZIP
PHONE
�s41Lt
ZIP
Actual Set Backs in Feet Exf
North 'South East
'West
Size of Parcel 1 Zone Classification
Type Const.
T`N
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
ADDRESS
PHONE
ZIP
luation
CGG
Main Floor
Upper Floors
Building Area in Sq. Ft.
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW ❑ ALT.
'BLD. ❑ PLMB.
❑ AD'N. -Ne RPL.
❑ MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not RBq'd.
DESCRIBE WORK
8. Flcz�7 ,W1 NE
VALUATION SOURCE
OF
UTILITIES
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 APPLICATIOIY--_- 1 /y` v SIGNATURE OF APPLICANI4
Q{�
GAS I ELECTRIC
WATER
SEWER
ILocation (Area)
II
NNE
USE CODE
Enum. Dist.
Ownership
Public ❑ Private
i
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
.NoT -2c6, p .
SEPA Checklist
SPECIAL CONDITIONS:
FLL.i✓l2
FEES COLLECTED
Single $
Building TT"+
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ k-
PERMIT NUMBER
02* * 1 44.00
* 144,00
* 144.006
*0.00
2a.2R
01-14-82
6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Building Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
01...14k-82
DATE ISSUED PERMIT NO. TOTAL
28.3S *14400a1 -