1981, 09-29 Permit: 81A-9983 ACPLAN 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
LEG‘,L GE..,CRIPTION - SEE ATTACHED
LOT
BLOCK SUBDIVISION
PARCEL NUMBER/S
OWNER
3 /. ih .1—h�V//1/
ADDRESS
4f/_ 22 Al
Pyr/k7
Z'19 03 7
Actual Set Backs in Feet
North !South
East
West
CONTRACTOR
4 8AA/A/z e "uA71v ' 4 -r/V6
PHONE
Z972
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Size of Parcel Zone Classification
Type Const.
Valuation
Main Floor
Occupancy
Upper Floors
Area of Decks
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
KAD'N. ❑ RPL.
OMECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
DESCRIBE WORK r
8. /4/, 9 �� ,.=4r.►0/49,1/ /-4C/6 -- yi/ ,61,44e �'�.c%z�i7r�✓ ,�
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist,
No. Rooms
Req'd.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
I hereby certify that I nave 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 INSPECTIONSS%
%
DATE OF APPLICATION f �7 " E``/SIGNATURE OF APPLICAr�J'y'�"
/T '%
SPECIAL APPROVALS
NAME DATE
Env. Health
Manning
Fire Marshall
Co. Engineer
Utilities
-dans Examiner
SEPA Checklist
uildi
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Storage
FEES COLLECTED
Single $
Building
Plumbing
Mech. /' ' CY1
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
04* *1400
* 1400
* 14006
A *0.00
9982
09-29-81
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-29-81
998,32T *1.4002
DATE ISSUED PERMIT NO.