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.