1981, 12-11 Permit: 81B-2654 Addition„'PLAN 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
S✓lADDRESS
' OI
LOT BLOCKSUBDIVISION ' I
2. (D, r'PO�'I"U N It`?
SjdKi��,.. _I n
AD) ESS 0.1` -
3.
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
PARCEL NUMBER/S 1-75-44
7 J `i
I — ( zI
Fi. CooI nk r 1 So
Actual Set Backs in Feet Isr`16'rN161
North 'South [East
(West
a. CIOMOR�61.zl�s� s ilk.
ADDRU65 .58 3 ` J
TM_ siik,
ZZII P
Z'VKI
Size of Parcel I Zone Classification I
I(II Ad1 set
h S'LII
Sprinklered
❑Yes 0No 0 Req'd.
Type Const.
Occupancy
5.
DESIGNER
PHONE
Valuation ) Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
OO NEW 0 ALT. BAD N. 0 RPL. 0 MVE.
E BLD. - 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK �v�ili�qJ� �
8. ;C TPI �e�+�tTl onl/3SeIt
VALUATION SOURCE GAS ELECTRIC WATER SEWER
a 1 / 5 C5. OF
UTILITIES
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not ,pq'd.
Enum. Dist.
Location (Area)
Ownership . J/
Public 0 Private IE
USE CODE
I hereby certify that 1 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 ° _ I/ SIGNATURE OF APPLICANT arta'
tsYl
SPECIAL APPROVALS
NAME DATE
Enj. H a h
Planning
Fire Marshall
Co. Engineer
Utilities
Examlp
SEPXCheckli
SPECIAL CONDITIONS:
cc*fr L'V (g6 12 - r -r- N1>70IJ1.)
PERMIT IS NONTRANSFERABLE
.PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
t`31 g4-
0,2* *29.00.
*29.00
*29.008
A . *Q00
2:6,5 3
)12-11-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
I
1;2J, E11'1; '8+11
216.:54:Z.
PERMIT NO.
:,2