1981, 06-11 Permit: 81A-5831 Sprinkler System. 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 • p
/ /�/ 5/
1. CT BL3CK�SU6 7SON`/
O
LEGAL DESCRIPTION — SEE ATTACHED
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
PHONE
ZIP
TO
❑ ALT. ❑ AD'N.
PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
DE RIB Ai�)
8 A ION SOURCE
OF
UTILITIES
9.
SEWER
PARCEL NUMBER /S
Actual Set Backs in Feet
North South East West
Size of Parcel
Type Const.
Valuation
Main Floor
No. Baths
Upper Floors
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
Storage
Unfin. Basement
No. Stories No. Rooms No. of Dwellings
CERTI FICATE
of EXEMPTION
Enum. Dist. Location (Area)
Ownership
Public ❑ Private ❑
Req'd.
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. SSE REVERSE SIDE FOR REQUIRED INSPECTR4 S
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engine
Utilities
Plans Examiner
SEPA Checklist
B
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
Q1-.CJ
TOTAL
PERMIT NUMBER
1
03* *9.00
*9,00 U)
*9.006
A *0,00
583.0
06 -11 -81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 = ;111' 8'1
DATE ISSUED
583,15
PERMIT NO.
*9.0 0.a.,I-
TOTAL
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
FINAL INSPECTION: /G.-7�/
` /mil f
N S E W
SET BACKS
DATE REMARKS:
'NA N NUM8ER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99280 / 1609) 4863615
APPLICANT:
COMPLETE NUMBERL!
SPA
1 5 PfiL••• art 10 MAKE 3 COPIES
5.
JOB A DRESS
• .„,,d
•
K.
/ / /!EIMiI/
hiffiN
LEGAL DESCRIPTION — SEE ATTACHED
ARCEL NUMBERS
Sue of Parcer
Occupants,
Sprinkler/0
Oyes 0No 0 Beg,
Building Area In S9. Ft.
ADDRESS
IP
Main Flom
Upper Floors Garage Area
Storage
CHANGE OF USE FRO
64
TO
ru of De
TYPE 0 NEW 0 ALT. 0 ACM. 0 RPL 0 MAE.
7. OF WORN ❑ 6LD. �PLMB, ❑ MECH. ❑ M.H. 0 POOL
❑ 0T050 CERTIFICATE
6 of EXEMPTION
Location (Arse)
FInINeO Basement I Unlln. BMemenl
a. Stories No. Rooms INo. of OWPIIInM
O E' RI BB W0
SOUgCE
UTILOITIE
ELEC
urn. OW.
Asa O.
Recd. of Rees a.
ATER SEWER
Dwnweinp
ellc O Private 0
VSE 0005
u ,.nnl km . 11,. ...one to
I, ,.. . ,. ! , •
Ty,. ' ■ cnn1Hll,l Wth ,he Ih
..,il,m14i.,...
t .I III. I H w0141,• . -niu.H ill, ,•, ..
I, ,.,, .11.1,)11401//11„ $ E II VI_NSE ':!01. 1( Ill 1 11111 I.I.
r <t• •11'1 r. .,IntN w i 1 ari
SPECIAL APPROVALS T SPECIAL CONDITIONS:
NAME DATE •
FEES COLLECTED
811161 8
Building J'
PlunlaIng
Mech.
P lan Check
SEPA
Mobile Home
O the !Sp iryl��
TOTAL S✓e`6C1
p
PERMIT NUMBER s83.1'
uie .900
.000
•0000
•000 0
't -11 -81
5 6479.