1981, 04-07 Permit: 81A-3178 Remodel(PLAN NUMBER
x/7/8/
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPQKANE,'WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. LO
CLO
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2.
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LOT f CK
2. /, ii 1.E
OV) NER
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4.
SUBDIVISION
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PHONE
ADDRESS
CONTRACTOR
ZIP
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S Oq 5" Y— /SAV
ti../a r
/y , (f 4 ., E/4. I) RA /A., ,P
Actual Set Backs in Feet 1 A
North (South �'yy East
Size of Parcel
9J
ADpRESS
ZIP
Type Const.
v— i'
Occupancy
West
Zone Classifica)ion
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
O NEW
❑ BLD.
(S ALT.
0 PLMB.
O AD'N.
O MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
VALUATION
91i
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 regulatiryg construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SOURCE
OF
UTILITIES
GAS
c
Enum. Dist.
Location (Area)
LECT Fi I C
WATER
SEWER
Ownership
Public ❑ Private t4
USE CODE
DATE OF APPLICATION "
SPECIAL APPROVALS
NAME DATE
Env. Health
' EL -LA 5 *NS/
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu ding Tec niciatr)
4a. 14- 1 A a/'
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
4612, ,. a7. 4
4 (.riK2?,,,,1. /�.4-1,_
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
PERMIT NUMBER
Stip-3108
02* *32.00
* 32.00
* 32.008
A *0.00 0
31662
04-07-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04'-07:-81
DATE ISSUED
317:82 *32a00417-1.
PERMIT NO.
TOTAL