1981, 06-25 Permit: 81A-6325 ResidencePLAN NUMBER 4'
RIla 1�
1.
2.
PLs'A It)
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
61 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
N . 33D4- nu)MANJ
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
Da K A QD
3.
OWNER
1
W.5 L.0 �lUL4� S
PHONE
4 r -tet fSo7
PARCEL NUMBER/S
b i534-azo3
ADDRESS
Lu. 3018 621411.10ULEW
ZI P
GNC{ Z6_3-4
4.
5.
CONTRACTOR
SA Ong
ADDRESS
DESIGNER
PHONE
Actual Set Backs in Feet
North 'South !Z
Size of Parcel
East 1 'West �-~+
Zone Classification
p 1 5u8,
ZIP
Type Const.
Occupancy
R3
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Val ion
tLQC) ? F616L9
Building Area in Sq. Ft.
q
ADDRESS
ZIP
Main Floor
6132
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Areay of Decks
VELD
Finished Basement
Unfin. Basement
32
TYPE
7. OF
WORK
IV:f NEW ❑ ALT.
VBLD. ❑ PLMB.
❑ AD'N.
O MECH.
❑ RPL.
❑ M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
i J
CERTIFICATE
of EXEMPTION
No, Rooms
No. of Dwellings
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Sink -SLE F'Ant Lam( hES OLE -
Enum. Dist.
ILocation (Area)
VALUATION
9. 32_, IOU
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
�SEWER
Ownership ,.,..,//
Public ❑ Private LY
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
rV
SPECIAL APPROVALS
NAME DATE
PHealth
4 6-1L0
Planning
Fire Marshall
/Co Eng- eer
1J .
Eng-
U i ities
Plans Examiner
SEPA Checklist
Building Technician
04#y y 767'
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building - ZcbZ .DD
Plumbing
ech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 20200
PERMIT NUMBER
E.
402-9
02* *202.00
*202,00 V)
*202006
A *000 0
61 632
06-22-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.0'61 4".51
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
632.52 *.0200 �
ioi )
V51 '3 Ff)1X.- I
31 • as -
.31.54i 1(c
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1-2(4,44.2
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