HomeMy WebLinkAbout1981, 12-07 Permit: 81B-2528 AdditionPLAN NUMBER
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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.
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK SUBDIVISION •
1 . NT14 ----6s,a ts A C�Ka ,N)
LOT
2. :Z
OWNER
3 J t 4. LO
ADDRESS
Cif`tou
CONTRACTOR
4. 5EIN�
ADDRESS
DESIGNER
5. ADDRESS
PHONE
PARCEL NUMBER/S
ZIP
Cl '7‘
PHONE
Actual Set Backs in Feet
North)'South S
Size of Parcel
tbv lc
East West (.94
Zone Classification
3u12:VO
ZIP
Type Const.
Occupancy
61-1
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
esa
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished
Basement
Unfin. Basement
TYPE
7. OF
WORK
0
�,/ry E W
LTJ BLD. 0
ALT. WJ AD N.
PLMB. 0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not‘7'd.
DESCRIBE WORK
8. A bp tT'ios.,J �ti -ATC 14Gt- Q Gaaft2.44e
Enum. Dist. I Location (Area)
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
WPTLc
Ownership � /
Public 0 Private Cii
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 SIGNATURE OF APPLICANT
. SPECIAL APPROVALS
NAME DATE
ESI alth•
`/` .ALJ /y7
anning
Fire Marshall
Co. Engineer
Utilities
Plans'Sxamin
hecklist
ing Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 6
PERMIT NUMBER
8' 8 257
02 * *56P.0
*56.00
*56:06
A *0,'a0
.247312
1 �2-07 -81
g '6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE• -
2,5'.2,;8 z *'S 6.0 0'a ;
PERMIT NO. TOTAL ,
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2,5'2, 8
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-0235
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