1982, 05-24 Permit 82A-4091 Demo ResidenceAPPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
i\LJMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. N 4
LOT BLOCK SUBDIVISION
2.
OWNER
3. Mu1v
�c cTczlG -Peg E.
ADDRESS C�
CONTRACTOR
PHONE
ZIP
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
Size of Parcel
East (West
Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
DESIGNER
rJ. ADDRESS
PHONE
Valuation
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
O AD'N.
O MECH.
DESCRIBE WORK
87-DO,r's kip
O RPL.
O M.H.
VALUATION SOURCE GAS ELECTRIC
OF
9. UTILITIES
❑ MVE.
❑ POOL
WATER
re OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private
USE CODE
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 doe not presume
to give authority to violate or cancel the provisions of any other state or local law regulating co ruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIQNS
- (.i
DATE OF APPLICATION S-24L
SIGNATURE OF APPL'r
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
SEPA Checklis
SPECIAL CONDITIONS:
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building 2C) irr>
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
02* *20,00
*2000
*20.006
A *000
409.0g
05-24-82
z 6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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ing Techniciac. 9 V
PERMIT IS NONTRANSFERABLE
0'S -1 2'. 409.1z *20,00a-12 _
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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