1981, 04-29 Permit: 81A-4093 Lawn SprinklerPLAN 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. Cac(D°I CA2LISLE
LEGAL DESCRIPTION - SEE ATTACHED
2.
3.
LOT
BLOCK
SUBDIVISION
OWNER
- Eto DOLLS
PHONE
PARCEL NUMBER/S
ADDRESS
E . (ADA CF10_t.LSL.E
ZIP
Actual Set Backs in Feet
North !South
East
West
4.
5.
CONTRACTOR
�t S?ettUKL6tt
PHONE
Size of Parcel 1 Zone Classification
ADDRESS
tox 5zo . Meko
DESIGNER
ZIP'
4wsa
Type Const.
Occupancy
5 p r i nkl er ed
Dues ❑No 0 Req'd.
PHONE
Valuation 1 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
Unfln. Basement
R'NEW D ALT. 0 AD N. 0 RPL. 0 MVE.-
0 BLD. 0/ALT.
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
s. LAto S2Qin. kLee_ StTEm
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
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 9- SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single -$
Building
Plumbing GC)
Mech.
Plan Check
SEPA
. Mobile Home
•
Other (Specify)
TOTAL $ l.Ct.)
PERMIT NUMBER
JeSiA-40c:13
03* *9.0'A
*9.00 N
*9.006
A *Q00 6
409.2
04-29-8;1
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'141k,''� ig'` ,g,11 4 1
0'91'3,`6
DATE ISSUED PERMIT NO.
*9.0.0Dale —
TOTAL