1981, 05-06 Permit: 81A-2120 ACPLAN NUMBER
(/
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1.
2.
3.
JOB ADDRESS
Non.th 1118 8a.e)s Road
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER'S
OWNER
LuJ JnCI?.PAt2
ADDRE
NoA.th 1118 BiitPA Road
CONTRACTOR
Powea4 . I nconpoaa.ed
4. ADDRESS
Eaust 6507 Mallon Avenue
PHONE
ZIP
99206
Required Set Backs In Feet
North 'South (East IWest
PHONE
535-7714
Size of Parcel 1 Zone Classification
ZIP
99206
Type Const.
Occupancy
Sprinklered
❑Yes DNo ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area I Baseinent Area f Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ NEW
❑ BLD.
O ALT.
O PLMB.
❑ AD'N.
• MECH:
❑ RPL.
O M.H.
O MVE.
O POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. 1 ea. 31/2 on ai.n condi-tionen
VALUATION
9.
Source
of
Utilities
GAS
.to pne4en.t 4y4tem
ELECTRIC
WATER
SEWER
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 I gulating construction or the
performance of construction.
DATE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATUR
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SSCIAL . ' 6ITIONS:
FOR CAS:
PIPE SIZES:
PIPE LENGTHS:
BTU'S
4 4-716* J3 ▪ &?Cr/Or:.5).:52 y�
DATE/ ' OFFIC
APPR
FOR ISSUANCE
FEES COLLECTED
Single S
Building
Plumbing
Mech. 6.00
Plan Check
SEPA
Mobile Home
dtne(g,-c\,) 1 0 . 0 0
TOTAL $ 16_00
PERMIT NUMBER
f4 2, t2—O
DATE Maach 5. 1981
04* *1600
* 1600 N
* 160,06
A *0.00 0
2'11.92
03-06-81
6479,
WFiIEN IVIAGHIIVE VALIDATED IN THIS SPACE
Tk1� 4TF rtra PER MIT. 2120 2
*16.000.,
a.
RECORD
iD)-09—ET )iso4 siqouo;
OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
Si