1981, 01-13 Permit: 81A-455 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. s z!2ff EVeR it.Ree-N
KoA D
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
OWNER
3 ea. LYLE. J. CLARK
ADDRESS
3- 212W- EV6RCfZE-E•N RoAO
PHONE
9z+-9/07
PARCEL NUMBER/S 275'41- 7o25( TNl N. 1001 LY`
THE S Z cF THE NE �, of -(1{E. SE * of 714E
IJE'�y. oK s4aoN 17- 15-411- Ext RUPPraGEEN
PA AO
VERA DALE
ZIP
9403'7
CONTRACTOR
4.
SAME -
ADDRESS
PHONE
Actual et Backs in Feet ^
North 7 'South isr% `East 16 T' (West
Size of arcel
/O0' /C 17ra0.8f
Zone lassificatlon
AGRtcatralfLAL—
ZIP
Type Const.
V-14
Occupancy
R-3
• Sprinklered -
❑Ves ❑No 0 Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation
.2552E3 r‘79..2.
00
Building Area In Sq. Ft.
2.93
ZIP
Main Floor
Upper Floors
Garage Area
• - 1 —
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
0 NEW 0 ALT. 0-A1-3 N. 0 RPL. 0 MVE.
LTBLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
r
DESCRIBE WORK
8. 4DDfT/DNiiXTENs/ON 6F RE0 STING
VALUATIO SPURGE
a OF
9.`G q2.o UTILITIES
GAS
ELECTRICif
WATER SEWER
•
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
R eq'd.
Reed.
Not Regrd.
Enum. Dist.
E.S NcE
Location (Area)
Ownership
Public 0 Private
E 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,nulating constlo or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION /e. / v / SIGNATURE OF A
SPECIAL APPROVALS
NAME DATE
Env. H 4th
PI nn g
Fire Marshall
7/3
Co. Engineer •
Utilities
Plans Examiner
s���l
1b1 PAo hin'&1.R,�ly
II IG'j p/
SPECIAL CONDITIONS:
MAIL -10 oVJJ„ie,
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 $ tZr
PERM'1-NUMtf_'R
- .015-.5-
0 2 •
SS
02'*' *6200
*6200 17)
*62.00
A *Q0,0 8
4352
01-13-8j
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
PERMIT NA.'l:.!5!d L . * V LIMT4LIJ-.
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