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1982, 04-14 Permit 82A-2794 MHPLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — LUILLD!NG CODES DEPARTMENT PERMIT NUMBER 779— NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES JOB ADDRESS I -72O 6 c LOT BLOCK SUBDIVTSION IJ� r 3. � W��0� cdURcF1-AI fit, PHOI+L ADD ESS CONT ACT 4. ADDRESS E 9 DESIGNER ADDRESS CHANGE OF USE FROM 6. TYPE 7. OF WORK G NEW EB L D. DESCRIBE WOR 8. V i V VALUATION 9. ❑ ALT. ❑ PLMB. SOURCE OF UTILITIES PHONE ZIP PHONE ZIP TO O AD N. O MECH. vlirJe GAS ❑ RPL. O M.H. ELECTRIC ❑ MVE. O POOL WATER 0 OTHER SEWER LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S 10 2 W i! or(,,114,..so c p,R), I5t,, Actual Set Backs in Feet North (South East I0 (West I° Siz of Parcel Zo - Classification Tyke onst. Occupancy Sprinklered Des ❑No ❑ Req'd. Valuation/4 let)L Building Area in Sq. Ft. Main Floor ( Upper Floors ( Garage Area I 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) Ownership Public ❑ Private USE CODE Req'd. Rec'd. Not Req'd. 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 INSPECTION DATE OF AFr' (CATION !3 SIGNATURE OF APPLICANT PECIAL APPROVALS NAME DATE Ping ire arshall Co. Erigine,er Utilities Plans Examiner SEPA Checklist Buildin Techni an SPECIAL CONDITIONS: 7 RA4,141c1 Ptru. getPa (1.401511, e) rf 0- rtic1.4' 44es5% O.) - ‘7tec,a4-16-Aje PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home 50 Other (Specify) TOTAL $ ro 07* *5C00 * 5C00 17) * 5C006 A *C00 234,32 0'3-31 a82 $ 6.479 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 0'4 4i-82 279.4.z *5O.0Oa� - a U LLJ u- DATE ISSUED PERMIT NO. TOTAL