1981, 04-01 Permit: 81A-2988 Sprinkler SystemPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETL NUMBERED SPACE' - PRESS HARD TO MAKE 3 COPIES
1.
2.
JOB ADDRESS
o) 1 14;22-C �. y � CA--rBLOCKi"'
SUBDIVI ION
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
OWNER j r
3. GetiS�
ADDRESS
r \6�
- " 7 n2-0 (:) t \i C.-I—
jt
COONTRACTO
4' / ADDS
N
PHONE
ZIP
Actual Set Backs in Feet
North 'South
East
West
I
PHONE
%C,<' S /
ZIP
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZI P
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW
❑ BLD.
0 ALT.
IIYPLMB.
El AD'N. ❑ RPL.
❑ MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. v.i i• �� �d t �� S` -ch ---
VAL ATI ON SOURCE AS ELECTRIC
OF
9. UTILITIES
Enum. Dist.
Location (Area)
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 TI S '
DATE OF APPLICATION �C)
SPECIA1_ APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF 'CANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
f
PERMIT 'LUMBER
03* *9.00
*9.00 rn-
*9.006
A *0.00
298.72
04-01-81
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04° Of' 1'1
DATE ISSUED
298.8'1 *9,00,a1-2:
PERMIT NO. TOTAL