1981, 11-23 Permit: 81B-2084 Fire Damage RepairPLAN 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
1 LOT
2.
OWNER
3. G� 4rV ry
ADDRESS
E. -742 t t
CONTRACTOR
4.
ADDRESS
E• -7 CD._
DESIGNER
5' ADDRESS
BLOC
E. —fit
K SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
ER�tKSGrJ
PARCEL NUMBER/S
ZIP
LE -4).0$ 4-- i tiACxve.o
Actual Set Backs i Feet
"161-t rli6jl
North South East
'West
PHONE
5 -8-13
Size of Parcel
ZIP
Type Const.
Occupancy
Zone Classification
4461. S txt3LArz an)
Sprinklered
❑Yes 0 N ❑ Req'd.
PHONE
ZIP
Valu;stion
0i�
Main Floor
Building Area in Sq. Ft.
t l �S
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW 0 ALT.
'BLD. ❑ PLMB.
❑ AD N.
O MECH.
KJ RPL.
0 M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
No_t/Req'd.
DESCRIBE WORK
�VAALUATION
�icn J
SOURCE
OF
UTILITIES
Enum. Dist.
ILocation (Area)
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private le
USE CODE
I hereby certify that 1 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 /ii/z3/O i SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
rlo-t zEQro
SEPA Checklist
Building Technician
�d
SPECIAL CONDITIONS: Li,,tr„
F 112E, o41-
F2-otr►t cn; C
1•10 i i2 .mac
-T6E. £:vG14A3EF.1 ..� 0
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 4* 2_3 ' ex)
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ '2.:J6.�i
PERM!' NUMZiER
ale- 2. oe04-
02* *23800
* 23800
* 238,00"
A *000
208,3 r
11-23-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
5le ,u { � -' g
DATE ISSUED
PERMITTID & 4 z *i2 3 O'TOY*Li"
19cA3-0609 BLHCv 78-2492 7900208566 G ERICK%ON 09/10'6 [h' PAID
FIRE JMPR[/vEV ||NlMPRUVED TOTAL LAND IMPR, TOTAL
ACRES ACRES VALUE ACRES VALUE ACRES VALUE VALUE VALUE YP [Y CODE
2000 29100 31100 81 264
7000 61700 687�', �64
00 00 61700 �8/vo
BEVERLY kilLL1::f 1, --co UF
LT% 9 & 10 8LK � DAF, LT 9 EXC BEG AT NW COR OF LT 9 TH %ELY ALG
NLY LN 30FT /H :::WL/ TO P7 ON W LN OF %D LT WHICH IS 54.51,l
NLY OF %W COP 0F LT 9 TH N ALG WLY LN TO POB & PIN OF LT iO DAF/
BEG Al ',..[LY COP OF SD 17 iO TH NWLy ALC SLY LN 22FT 7H NELY TO E/i
i9543—O6O9
PT ON E LN OF SO L7 10 WHICH IS 54.5FT NLY FROM PUB TH J ALG
%D E LN OF L[ 10 7O POB