1981, 03-13 Permit: 81A-2392 ResidencePLAN NUMBER
5/,‘yv
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
( 4j7
LOT LOCK
. t °'
OWNER
3 I� ;i t
ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
0 ..7 E _ 2-o `)
204,
Actual Set Backs in Feet
North 'South
East
West
4.
CONTRACTOR
�rjl v 1ti
ADDRESS
3C--)f)
5.
:MEE
Size of Parcel
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
�NJ,rJNEW ❑ ALT.
L✓J BLD. ❑ PLMB.
ZIP
9O (2
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
jUzf, 1.77
TypeCpnst. ¶ Occu anc
N 1j7,
alu tion
V 9/
Zone
Classification
.
LA:--';
r.
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
1656
Main Floo
pper Floors
Area of Decks
Gar ge Area
r
).e
7! 'a
Finished Basemen
No. Baths
No. Stories
No. Rooms
Storage
Unfin. Basement
17-
No. of Dwellings
1
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIla WORK
E
VALUATION SOURCE �I GAS - �ELECTRI WA ER
OF
9. UTILITIES C.C>I , L
SEWER
Enum. Dist. I Location (Area)
Ownership USE CODE
Public ❑ Private
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 .resume
to give authority to violate or cancel the provisions of any other state or local law regulating constru or the
performance of construction. $EE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
SIGNATURE OF APPLIC$■NT
SPECIAL APPROVALS
NAME DATE
Fire Marshall
o. Engineer
/1— 01
Utilities
Plans Examiner
To 'PD s n..,toArr 3ic1si
SEPA Checklist
SPECIAL CONDITION'S:
C Mr--- ?,j r I3 /A I)
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not R
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUM3ER
02* *2920,0
* 2920,0
* 2920,0
A *0.00 8
220,12
03-09-80
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0
'6 '1i
DATE ISSUED
239.2'Z *292.00 JO
PERMIT NO.
TO T A (_.
r
E I "1= 20 -0
11'311 :120 i l Ni 0/5.:
! Pam N 5 riR&1' . ilDD1 aN• GR L1 GRE6,
21'c c 1 t -i' to P, e>155.4 - ZOa to
R it f 5 c r 0 P L 2 1 is .e _ 1 . I. rcrai