1981, 09-10 Permit: 81A-9132 CO InspectionPLAN 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
U loci •-bc.)p C.
LOT BLOCK SUBDIVISION
2 7 I .foiiIC. 5 d'tq kv IvrietZ1 t,,,c,Z+c 37.(s:: -C 064
OWNER PHONE
ZIP
C CA0VCI
ADDRESS
D cv4vNt.ucci1j •
4.
CONTRACTOR
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6. RtS.'bi
TYPE
7. OF
WORK
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
ZIP
PHONE
ZIP
TO
Rtstb Educe cbFFic,E.
Actual Set Backs in Feet
North South East (West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Area of Decks
Building Area in Sq. Ft.
Garage Area
Storage
Finished Basement Un in. Basement
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
VI/OTHER
DESCRIBE WORK
8. ` .C.ckAL 1N '?mac= %4OW
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
FOQ. E Q.,
ELECTRIC
WATER
SEWER
No. Baths No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
Location (Area)
Ownership
Public ❑ Private ❑
Req'd.
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 APPLICATION j0' -R SIGNATURE OF APPLICAN
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Byjlding Technician
SPECIAL CONDITIONS:
2 2 7-7,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) S`C)c)
TOTAL $
PERMIT NUMBER
OtA
02* *800
*0,00
*8006
A *0.00
913.1
09-10-81
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11,9114110i.
DATE ISSUED
8 '1
913.22
PERMIT NO.
* 8. t* 8. 0 0
TOTAL