1981, 09-08 Permit: 81A-9014 AdditionPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
1.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
4o4 BAnIA 011
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2. i3
OWNER
3. Firi.>YO
ADDRESS
N
Azt-ori
CONTRACTOR
ADDRESS
r`-J` AYv
DESIGNER
BLOCK
4.
5.
SUBDIVISION
_ //0441.L,'I 140 ' irtEn, r -nom
D/\ a Nc(
PHONE
et 2.e
ZIP
P RC>� EL NUMBER /S
C55�-1. -4.1 i3
Actual Set Backs in Feet
North 'South 10
1
East West �
PHONE
ZIP
Size of Parcel Zone Classification
tv x 124 ArPi204 AcxtitC_ <L&e_AL
Type Const.
Occupancy
Sprinklered
Elves ONo ❑ Req'd.
PHONE
ADDRESS
ZIP
Val tion Building Area in Sq. Ft.
t
Main Floor
q00
Upper Floors
Garage Area I Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
eNEW ❑ ALT.
lid BLD. ❑ PLMB.
M/AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
•
No. Stories
No. Rooms
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
100 T tc.4%..; -Th
i0 U
Enum. Dist. I Location (Area)
VALUATION
9 3i/4C
SOURCE
OF
UTILITIES
GAS I ELECTRIC
WATER
SEWER
Ownership f
Public ❑ Private t7
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 local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION SIGNATURE OF APPLICANT 7��C�'�`"
SPECIAL APPROVALS
NAME DATE
Env. ylea
Planning
Fire Marshall
Co. Engineer
Utilities
eohti 9/6'
Fitss Ex ne'lA/
a,„ list)
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Recd. Not Req'd.
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
44. &o
TOTAL
$ 44.06
PEP,2^IT NI "MEIEF.
02* *44,00
*44.00
*44,006
A *0,00
901.3
09-- C,8 -81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
t
:0:9! tai '81'' 9014g *.44002 l'�- —
DATE ISSUED PERMIT NO. TOTAL
19
sep /,C
1d 1'
SCA L G % - / -a
1 4/
Not Pi AN