1982, 03-08 Permit 82A-1521 MHPLAN 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
LOT BLOCK SUBDIVIIN
OW ER
3 �V IyyIC J c2 iR " J C "( �� c'7cJ f iK
A DD&S7 ,UI I
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CONTR kv t,
4. ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
PHONE
PHONE
ZIP
PHONE
ZIP
TO
YJ NEW ❑ ALT. ❑ AD N. ❑ R L. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH. L`J M.H. ❑ POOL
0 OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs In Feet es
No th ISouth6^S East 'West
Size of Parcel Zone Classlficatlon �
C� r�•S • LIY .
yp, C nst. Occupancy Sprinklered
V k R ❑Yes DNo 0 Req'd.
Valuation,_{ Building Area in Sq. Ft.
. / 7% riele 440
Main Floor I 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
8 DESC Ord I4� J ( 71- x J\ Enum. Dist. Location (Area)
VALUATION SOURCE GAS ELECTRIC ATER SEWER
� Ownership USE CODE
9. UTILITIES � '�Ct Public ❑Private
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 t 4/ /C
// `-SIGNATURE OF APPLICANT(''
Req'd. Re"d.
SPECIAL APPROVALS
NAME DATE
Env.I-193Ith
PInning
Fire Marshall
Co Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
/3-gZ
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home 10
0
Other (Specify)
TOTAL
PERMIT NUMBER
NA- - 611
07* *100.00
*100.00
*100.006
A *0.00
1 52.0r
03-08-82
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Buil
Te:1.1ptet�
G `
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
!:E-70%8 �' 812'
DATE ISSUED
1'S2,15 *100,0.0Q.�
PERMIT NO. TOTAL
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0 !ii?o PC:4 rr
the,
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I Is
4li3 `ry y % \' - _ 60_
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