1981, 05-01 Permit: 81A-4225 ResidencePLAN NUMBER
-
671/g/
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
Aie
Jr ADDRESS
'**-1/
�ABLO C a
LOC SUB IVISIO�1
T
2.
3.
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
ADDRESS
71. 6 e 4 i ��ii.�.t�'r✓r vr'tlil�C T=
CONTRACTOR
4. A411
AD
DESIGNER
PHONE
SOD
PARCEL NUMBER/S
(4.1-1- OF N OF .E OF TR14 LT /87
£ F VERA
ZIP
9'9
Actual Set Backs in Feet
North .22 South,q
East /
/
West 7d
5.
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
V -N
PHONE
Valuation
Occupancy
R-3
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
/
ADDRESS
ZIP
M
g3/
ain Floor Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks Finished Basement
Unfin. Basemfnt
77S
TYPE
7. OF
WORK
NEW
BLD.
❑ ALT.
❑ PLMB.
O AD'N.
O MECH.
O RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
/
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
D SCRIBE WORK
8.,�,Q,,.. .1J.; - -�,c a,lc lz- P� . �'I
V LUATION SOURCE GAS ELECTRIC WATER SEWER
OF
UTILITIES
9.34
Enum. Dist.
Location (Area)
,27aaZ:c-
Ownership
Public 0 Private Dir
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 l - 4—ei SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
ealth
SPECIAL CONDITIONS:
�� fie.44 ../ /e
/— S- /7.2/o
Co. Engineer
Plans Examiner
'fu ro,-r IIA I -r 7/if1
-SEPA Checklist
8/
•
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
PERMIThyIMBF
Fl 4--2Z�
* 215.00
• ' ;1:0
* 21500L
*GC,5
11688
02-04-8,1
6479,
123
L1 i ,.
Single911
$
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify) C-23,
TOTAL $ - s
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT,
0511; `i. "8!i 4225 *2.6&O.O V
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
L
A.491:21Ze-ii-2 122 e;, V4i
w
LA kl
ENJ !z17. -
vt/
1 -- MEL II=MNSMISM..& in AM.. 00O1 a Ilk
OFFICE OF THE
SPOKANE COUNTY PLANNING DEPARTMENT
Bulldtng Codes Department _
Mit Planning Departrnent
t 1140dtnq Permit
Data Ilyed 15 ,197?
1 t,c t.tt,t t , 1 1 E,J titti It[ t.a:, t . c: tvl_ 1 .i t i ,i,ic ..l t u,
t()t tltu
ot bulldhny pt. hitt on the roperty as described on
the attach d affidavit/legal description. it has been
determined that a building permit should be issued
under the provisions of RCW 58.17.210. This memo
and attached affidavit/legal description must accom-
pany the building permit application.
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