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1981, 05-12 Permit: 81A-4645 Residence Finish Work1PLAN NUMBER 67iz /8/ 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 1&11 \L�� )10, LOT BLOCK SUBDIVISION �� I • ?? %mil Nf F s ^00 - i<w'IJ 3. ,�'1- F6'A�o0� fzjU �Y=�1 ��C' ?)3--6 .- d ADDRESS / �r � � �P�2- ;0 C� PHONE 4. CONTRA Tci 1 ADDRESS DESIGNER ADDRESS CHANGE OF USE FROM 6. TYPE 7. OF WORK LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER /S rim 01 ors, 0, 77 55+ — 1 fo 'cod <t, 67 ZIP PHONE ZIP TO ❑ NEW ❑ ALT. ❑ AD'N. I)/BLD. ❑ PLMB. ❑ MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL Ili OTHER DESCRI -E WORK VALUATIO 9. fir; SOU R OF UTILITIES GAS WATER 3'i=WER Sprinklered Oyes ❑No ❑ Req'd. Valuation 55 —n0 °v Main Floor Upper Floors Area of Decks No. Baths Building Area in Sq. Ft. Garage Area Finished Basement No. Stories CERTIFICATE of EXEMPTION Enum. Dist. Storage Unfin. Basement No. Rooms Req'd. Location (Area) Ownership Public ❑ Private ❑ USE CODE No. of Dwellings 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 presu e to give authority to violate or cancel the provisions of any other state or local law regulating construction or t performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS DATE OF APPLICATION SIGNATURE OF APPLIC SPECIAL APPROVALS NAME DATE Env. Healt i Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist echsicia. SPECIAL CONDITIONS: 0 r Vi- 7-- 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 $ S0 PERMIT NUMBER 0 * *5600 * 5600 * 56.0.06 A *000 8 1 09.22 02 -02 -81 2 6[t79 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. l � 05;71.-4.2-71811.`: DATE ISSUED PERMIT NO. TOTAL 46452 *56,00 0.