1981, 10-27 Permit: 81B-1136 AdditionPERMIT NUMBER
.?%.113- 113Ca
PLA UMBER
//9 a/7
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
ti
DDRESS
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK SUB 1 ISION
A1/440, e
3.
„176L.,1 . t C)N.1NJ IV PHO E
PARCEL NUMBER/S ' o4-
►I '4.., c - L '1 �Ll
ADI ESS _
E3 -2 --
ZIP
,
G
Actual Set
Backs in Feet
North IS ISouth
CONTRACI.TOR
4' ADDRESS
DESIGNER
rJ. ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
PHONE
ZIP
Size Parce
TYper Cpnst.Nit N
Occupancy
V�7
Valuation Ft.
East 'West
Zone Classification
Building_Are� Sq.
1A,
Sprinklered -
❑Yes ❑No ❑ Req'd.
I2/9 <0 7
Main Fldor
per Floors
J
Area of Decks
TYPE
7. OF
WORK
W ❑ ALT. �AD'N. ❑ RPL. ❑ MVE.
BLD. ❑ PLMB. ❑ MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
Garage Area
Finished Basement
Storage
Unfin. Basement
No. Stories No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not eq'd.
DESCRIBE WORK
8.05e7IV ^0°11C r27 -c)-4-)
Enum. Dist. I Location (Area)
VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF
9. UTILITIES ' .1 �.., ttei
I hereby certify that I have read and examined this application and have readlthe "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 cons,truction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION iQ&01.,4,/ SIGNATURE OF APPLICANT
Ownership USE CODE
Public EDPrivatetrf
SPECIAL APPROVALS
N! -AME DATE
Fire Marshall
Co. Engineer
Utilities
0
Plans Examiner
SEPA Checklist
Tech
�101110
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building C '
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ,652.
02* *98.00
*9800 N
*9800
A *000
101.2g
10'-22-81
2 E. 479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
1116 Z
PERMIT NO.To
*98,00.21 -
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