1981, 06-01 Permit: 81A-5338 SidingPLAN 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 3 COPIES
JOB ADDRESS
LOT L
44asK 5 I ON U VI ON B
LEGAL DESCRIPTION — SEE ATTACHED
3.
0.1E R
65<ne k1 . S-forer-
PHONE
PARCEL NUMBER/S 1+*At r 2-50
0 7
ADDRESS
N , 0105 P5f WIad
4.
5.
CONTRACTOR
m 'Jai{ Br -D.41215 (1.pn irs
ac±r
ADDRESS
31e-) A-raan QQ 12rx d
DESIGNER
ZI P
P
( g-468
Actual Set Backs in Feet
North !South East (West
Size of Parcel
Zone Classification
PHONE
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
�❑ NT/NJI� ALT. 0 AD'N. 0 RPL. 0 MVE.
E BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL
DESCRIBE WORK
8. 3d II
VALUATIONIS6URCE
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Req'd.
---med /I is UTIOF
LITIES
GAS ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private ❑
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 ''PLICATION 9 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERAB
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $50.
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$50.00
PERMIT NUMBER
g7 s33g
u2* *50.00
*50.00 17)
*50.00'6
A *0.00
53372
0'6-01-81
z 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED • PERMIT NO. TOTAL
5333 400,0i0J.0