1981, 06-11 Permit: 81A-5829 Sprinkler SystemPLAN 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
.41 ADDR
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1
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2.
LEGAL DESCRIPTION — SEE ATTACHED
OWN /!�$/ I iii:( ogY
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DDRESS
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5.
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SIGNER
Z4?/&
PHONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
Type Const.
Valuation
Occupancy Sprinklered
❑Yes 0No 0 Req'd.
Building Area In Sq. Ft.
'ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE
7. OF
WORK
0 NEW 0ALT. 0 AD N.
❑ BLD. XPLMB. 0 MECH.
0 RPL.
❑ M.H.
'0 MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESC IBE.WOR / "/�J /�y/,///j
'��TION SO/ /4
ELE RIC ATER
OF \
9.
UTILITIES
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private 0
USE CODE
I hereby certify thati 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 INSPECT' INS ,.
DATE OF APPLICATION 051
r/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA ChecklIst
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 B/L=
PERMIT NUMBER
SIA -54529
03* *9.0.0 -
*9.00 tn-
*9.006.
A *0.00 S
5828
06-11-84
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
U6lio�iii� a iii
DATE ISSUED
5.B 2'9;Zi.
PERMIT Nb.
*9.0.0 d'. -
TOTAL