1981, 08-13 Permit: 81A-8102 ReroofPLAN 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
1. E. t Z k t C\ c s+N 6-C
LOT BLOLK
2. 5
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
HEas-rrzorv\` t E\c o —CCJ (� t uc41
OWNER`
3. .3cANNe �1i(iE
ADDRESS.
"C , \2..004 - ESPr\6T
CONTRACTOR
DR
4' ADDRESS
PHONE
PARCEL NUMBER/S
15542_-1ioS
ZIP
Q6424 c
Actual Set Backs in Feet
SKI. ES -rt
North !South East
'West
PHONE
Size of Parcel
e K.S 1 t PIC\
Zone Classification
U13.
SwhE
ZIP
Ta Const.
Occ u pa ncY
R3
Sprinklered
Oyes ONo 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
V4atlon PFJ 1 Building Area in Sq. Ft.
000.— 11
ZIP
Main -Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
• Area of Decks
Finished Basement
Untin. Basement
7.
TYPE
OF •
WORK
t. N, NEW 0 ALT. 0 AD N. YJ RPL. 0 MVE.
B] BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.P.C--grs ' R.csi0Istic.0
Qa VALUATION
N1�
SOURCE
OF
UTILITIES
Enum. Dist.
Location (Area)
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private
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 INSPECTIO
DATE OF APPLICATION'
D
�/ / SIGNATURE OF APPLICANT ( LI////iCC/ /�(
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checkl
din
r.o
Technicia
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building CO
Plu bing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 17.Oo
PERMIT NUMBER
eiA -81172
0'2* *17.00
*1-7.00- ti
*17.006
A - *Q00
8'1 Q.O�
-81
6479.
s
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
LI:H[7413 it O. 11
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
8102.2 *17.00aF-
PERMIT NO. TOTAL
O
L
LL