1981, 01-27 Permit: 81A-868 SidingPLAN r UMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BU;l_brvia CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
JOB ADDRESS
rnn e
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OW4
5R bA n,lfTrappL.
AD ESS_ r
515 a -one.
4. COMAE-V(1.11
OAEO/ii1 aro-/-
r
ADV 73/N, Ogoad
DESIGNER
5.
PHONE
irci
ZIP
49��aro
PHONE
PARCEL NUMBER/S
i`ac54'1-O6t
Actual Set Backs in Feet
North 'South [East (West
Size of Parcel 1 Zone Classification
PHONE
Type Const.
Valuigion
-H31bWU
Occupancy
z. 3
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
8.
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
DESCRIBE WORK
Sit/ 49Stclx..—
GAS
VALUATION
9-0-516i3,00
SOURCE
OF
UTILITIES
❑ AD'N.
❑ MECH.
El RPL.
❑ M.H.
❑ MVE.
❑ POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
ILocation (Area)
Req'd.
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
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
i/013/v__
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
(BuilTe`hnic
PERMIT IS NONTRANSFERABI
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $3 "V
PERMIT NUMBER
81A-0
02* *3800
* 3800
* 38,006
A *000
86.7
01-27-81
g 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'1-2 7-81 85.8'5 13'&00
DATE ISS;L PERMIT NO. TOTAL