1981, 09-11 Permit: 81A-9173 AdditionPLAN 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
1.
2.
3.
4.
JOB ADDRESS 1 ' I
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
c' tV5I1J APO' to \ ki2scf,
OWNER
C(/r `�ks
ADDRESS V7 ` /fly i I, •
CONTRACTOR
Mots (2- .�
ADD REIS, � 12- I i 1� t`� I
PHONE
PARCEL NUMBER /S
raj . 1•451'41/ pSutGt I(Q , G. vi I 104. �'P,�
Actual Set Backs in eet
North ..Qc%'South
East
'West
PHONE
` `j -6715
Size. of Parcel
00 X -?'i
Ty p�,do n st.
Zo a lassificaiion
LC
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation
307 �2
Building Area in Sq. Ft.
ZIP
Main Floor Upper Floors
Io%
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
TYPE
7. OF
WORK
0 NNEW ❑ ALT. 2 AD'N.
IF'J BLD. ❑ PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Area oi Decks
17-'0 G0\%
No. B hs
Finished Basement
Unfin. Basement
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not R
DESCRIBE WORVC 111C-4\!
8. t96KCe \ 190
P
�( 11'- Gc'vO
ELECTRIC
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
WATER
Enum. Dist.
ILocation (Area)
SEWER
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 lo - .w regulating construction or the
performance of construction. SSE REVERSE SIDE FOR REQUIRED INS' CTIO S
/DATE OF APPLICATION
ECIAL APPROVALS
heAME DATE
E
H 66x1 t h
Planning
Fire Marshall
Co. Engineer
Utilities
Pla Ex
,/
_ SIGNATURE OF APPLIC
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
4
PERMIT NUM.WR
tp _ct
02* *44.00
*44.00 N
*44,006
A *000
91632
09 -11 -81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0`9= T1'f .-t8
DATE ISSUED PERMIT NO. TOTAL
917.32 *44OOai -
17)ti 9 0\1(-0
1100 rrioKI
19o1