1981, 07-16 Permit: 81A-7122 Addition(PLAN NL'1IBER
•
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
1. < !I�CJ�,�v►
OT LOCK SUBDIVI ION
2. 1
LEGAL DESCRIPTION — SEE ATTACHED
tAK -( pAkIN1F
OWNER
Ape4_ J -
e
CONTRACTOR
4. J
c> -r An),
PHONE
� .? '47363
PARCEL NUMBER/S
17?2
Actual Set Backs in Feet
1South East
North
1 W est
PHONE
I� ?, - 500 f -j
Size of Parcel
ADD_RES&:.1:„. 0 r i vl j t`
DESIGNER
5' ADDRESS
PHONE
Typ}nst.
N
Zone Classification
'''5it445( 4\11 --
Valuation
�. G�
ccupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building A[ea,in Sq. Ft.
ZIP
CHANGE OF USE FROM
6.
TO
Mai Floor
Ar @a of Decks
Upper Floors l Garage Area
Storage
Finished Basement
Unfin, Basement
7.
TYPE
OF
WORK
❑ N ❑ALT.
1. ❑ PLMB.
D'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. E}aths
No. Itories
No. Rooms
No. of wellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
NotpePd.
8.
DE CRIBE
lWO•L /zO i rcAI
Enum. Dist.
ILocation (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership USE CODE
Public ❑ Private
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 gulati onstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT!' or;
DATE OF APPLICATION 7
SPECIAL APPROVALS
NAME DATE
Env H alth
anning "/
Fire Marshall
Co. Engineer
Utilities
PlansExaJJminer
SEPA Cllheck( t
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
LIG-WiG I 619��'� 1.
v
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
36-
PER
MIT N.,'M"
--7122
02* 1*68,00
+*680.0
(*68.006
A *0.00
71 1.7
07-16-81
02* '* 1 800
'* 1 0.0 01—
s* 1 8,006
*0,00
71212
07-16-8J
2 66.79
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
r !I
DATE ISSUED PERMIT NO.
712 2 z
* 8 6, 0 0
A
1