1981, 04-10 Permit: 81A-3361 ResidencePLAN NUMBER
i2,3i - ,a
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
LE +I 1511‘1119k1
LOT BLOCK SUBDIVISION
1 1 = �►r�I� c.11
3.
OW ER
ADDRESS
930
CON GCTOR
4. ADDRESS
riot-,-T- A9 elKNAc-
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
7-00 -7.
(7)
924-'0 35(`'
Z/ /� North Actual Set BacklSou: I East l� IWest
PHONE S ize or Parcel Zone Classification
ZIP
PHONE
ZIP
TO
,�WNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
Lr" BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
. rM,
T pe Const. Occ pancy
Valuation
Sprinklered
Dyes ❑No ❑ Req'd.
12t4r
Area of Decks
Upper Floors
Building Area in Sq. Ft.
Garage Area
Storage
No. Baths
DESCRIBE WOR
�� 1A1/ &-
VALUATION
1 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 •resume
to give authority to violate or cancel the provisions of any other state or local law regulati g constru to or t
SOURCE
OF
UTILITIES
GAS
ELECTRIC
Finished Basement Unfffinn. Basement
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not2.3ced.
SEWER
Ownership USE CODE
Public ❑ Private
performance of construcxion. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
P420--.2)1-1.-- SIGNATURE OF APPLIC
SPECIAL APPROVALS
NAME DATE
Env.
Planning
-Lee, W7
Fire Marshall
C
Utilities
Plans Examiner
SEPA Checklist
Bui` Te / ia� —e
SPECIAL CONDITIONS:
CONS � I � . sl ., � IN -2
ql i
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 $ Z . 0°
PERMIT NU :ABER
SiA-33 /
02* *289,00
*289.00
*289.006
A *0,00
32262
04 -08 -81
2 61179.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0147, -g 1
DATE ISSUED
PERMIT N303 6 1 Z *2 8 7 fle
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