1981, 03-23 Permit: 81A-2698 AdditionPLAN NUMBEk
3/a./8/
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
2.
JOB ADDRESS
p %
i - 111
LthT BCK ///P��iBe ////
t7. v 6S/y/ .(,(�CX s 7
OWNER,
3. //1.1i_JiA6J
ADDRESS
74, -t��, � (?� /)'N'f.- 4 �t %� f�../'l.[ J ,4- 447.
CONTRACTOR
AD,pRESS /
4.
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S/i/...
r 151- r'L3
' / /E-7?k 4j,4 Lf 1-74E/7/7‘ 7== /..z ;if .A- CD
ZIP
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
10 NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
ZIP
PHONE
ZIP
TO
w AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
Actual Set Backs in Feet
North South
Size of Parcel /
Type Const. Occupancy
71.11- .^.
East �.. 1 West '
Zone Classification
$prinklered
❑Yes ❑No ❑ Req'd.
Upper Floors
8.
DESCRIBE WORK
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
No; Baths
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Storage
Unfin. Basement
No. Rooms
Location (Area)
Ownership
Public ❑ Private yI
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 ' —d -&'/
SIGNATURE OF APPLICANT 'S/��� :�� rte.
SPECIAL APPROVALS
NAME DATE
Env/ Ith
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BuAldingTeciciani.
(( a.A % '
SPECIAL CONDITIONS:
/dX4/ 4;,c('/( 4NL7 c'_/J✓ca-r -- sQ�T
i'OX /i} Cd V.eiR et/Elf AiST//14
A':4_ . .4e�
•
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
n
TOTAL
PER N,4.11- !`_ LIME ER
/A -Q(r
02* *1300
* 1300 67)
* 13006
A *000
261.62
03-20-8,1
z 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0'13
DATE ISSUED
2 6 9.8'Z * 13.0 O a -
PERMIT NO
TA L: