1982, 08-02 Permit 82A-6644 SidingPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY -BUILDING CODES DEPARTMENT
PERMIT NUMBER
_ (A-4--
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
JOB ADDRESS
. 14 3a c2 f road u..:rxc'
LOT BLOCK UBDIVISION
OVINER
ADDRESS
• 14 3D &t'ar/CU- _t_
Cp NTRACTOR
4. C L Cui EA4__7_"� (-2-t S
A/07E S(O/ Air i' e /OCLC
DESIGNER
5. ADDRESS
PHONE
(w-L15.3g
ZIP
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North ,South
East
West
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy Sprinklered
Dyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
CHANGE OF USE FROM
6.
TO
TYPE
7. OF
WORK
8.
D NEW
❑ BLD.
DESCISJSE WORK '
ION SOURCE
OF
UTILITIES
VALUAT
❑ ALT.
O PLMB.
❑ AD'N.
ZIP
0 RPL.
O MECH. 0 M.H.
AS
❑ MVE.
❑ POOL
%OTHER
1 tt
ELECTRIC
WATER
SEWER
Main Floor
Upper Floors
Garage Area
Storage
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Ownership
Public ❑.Private ❑
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____
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
02* *54.00
*54.006
A *0.00
664,32
08-02-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Tecl
PERMIT IS NONTRANSFERAB
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
O8 62_82'
DATE ISSUED
66445
PERMIT NO.
5 OI
TOTAL A