1981, 06-25 Permit: 81A-6324 ResidencePLAN NUMBER
-Bt -C1
sop lc_ ?i_A-0
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
LOT
. 2
!\1.33\2 PpvtiJYv1A'J
BLOCK SUBDIVISION
1 OR.C.RN O AU'ENU.E T\CPLAT t
OWNER
3. 1`Y c u1 L.OE(2s
ADDRESS
110. 3U)L? C'1PANOVILK)
4.
CONTRACTOR
ADDRESS
Sew
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
li NEW
BLD.
❑ ALT.
O PLMB.
PHONE
46V-cil
ZIP
0142_ b4
PHONE
ZIP
PHONE
ZI P
TO
❑ AD'N. 0 RPL. ❑ MVE.
O MECH. ❑ M.H. 0 POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
0 t 63A D2 O2
East —77 A Z� West 4ai
Size of Parcel
&7Y 140,_3
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Main /Floor 1 Upper Floors Garage Area 1 Storage
1006
Area of Decks Finished Basement Unfin. Basement
DESCRIBE WORK
• 3LNCILE Filmt('( l� `J1OEv\
VALUATION
9.132/74L0
SOURCE
OF
UTI LITI ES
GAS
ELECTRIC
WATER
SEWER
tC
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist. Location (Area)
Ownership
Public ❑ Private
No. Rooms
4
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
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
En Health
dIe d.L_ 2 G ����i
Planning
Fire Marshall
/Co. Engineer
fl�I
'Utilities
Plans Examiner
SEPA Checklist
Bugcian
pian
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)
'021Dlo_a_D
TOTAL
$ 2069
PEG',11T N e •JIBER
0CA-����
02* *20600
*20600
*206.006
A *000
6162
06-22-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ir
•
DATE ISSUED
63242 *206.00a°�
PERMIT NO. TOTAL
4J,,1
_U
10
5 Dl
19-2
It
IO)
1Gc)1
-..
No
f5 r -14L.: ' eo t2
)
H :3,71
Z_
�--QT Z_
cco :1-11 i
,
Y. fes,
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