1981, 06-12 Permit: 81A-5856 MHPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
3.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB 74Lf DRESS
�GJ UU e-kftblJle-Le gv.
LOT BLOCFUB VISION
OWNER
TCwARD D, YY\Ooi2E
ADDRESS
4.
5.
35o4 CitiFJO
CONTRACTOR
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S -T3 b& \4, ‘4OI OF
Gc Ni iZ vF 3yt c• --F NW Y4ov: 3t14 OF NW 141-
Z33L—Ql7L
ZIP
aG2L7.3
Actual Set Backs in Feet
North South 10 1
East 30West
PHONE
Size of Parcel
Six 135
ADDRESS
mF
ZIP
Type Const.
Occupancy
12.3
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
PHONE
Vuation
&:),000
Building Area in Sq. Ft.
13444-
ADDRESS
ZIP
Main Floor
t3' 4
Upper Floors
6.
CHANGE OF USE FROM
TO
Area of Decks
Garage Area
Storage
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW
❑ BLD.
❑ ALT. ❑ AD'N.
O PLMB. 0 MECH.
❑/RPL.
LJ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
5
No. of Dwellings
t
DESCRIBE WORK
8. —t.A?;,/_E IUE
VALUATION
J
SOURCE
OF
UTILITIES
Mbar LC 14Orrir, ('21Sx
WATER SEWER
SEPIIC
GAS
ELECTRIC
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownership / USE CODE
Public 0 Private N
Req'd.
Rec'd.
Not Req'd.
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 c, lstruction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
qr 1
SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Plannin
0-/
WetT ntO -
Fire Marshall
I q( o.1
utlii les
Plans Examiner
SEPA Checklist
Building technician
SPECIAL CONDITIONS:
SE.6e c;ft7Eo tarn 21 )-
, 4, `Ailed
ctero'rS 1\11-
c S"F'tkC, Co t
(k T' v \ �T I S NT
n tl {{ p t
t(��tii`;11JI1T EX'IRES ONS EAR
ttbeof
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile HornrQC)
Other (Specify)
TOTAL
$ tbO.Oc
PEBEP C1
07* *100.00
*10000
*100006
A *0.00
54 1.3.2
06-03-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
AT ISSUED
585.62:' *
PERMIT NO.
00.0.1--
TOTAL
a'
IN'