1983, 09-26 Permit: 83A-9495 Soffit, Fascia(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
1.
2.
JOADDRESS
1/O/oact
LOT r //O t
S BDIVISI N
LEGAL DESCRIPTION — SEE ATTACHED
OW_ R
$./ ar,iuye
ADDRE4,5
log 7-17t
CO. TRACTOR 11. __
4. r UN $ �, (rah -466(5i
A RESS _
3 d
ZIP
906
DESIGNER
5' ADDRESS
Arcd
PHONE
9 �7 L6,k4
PARCEL NUMBER/S 07,'0 r_Jo
Actual Set Backs in Feet
North 'South 1East IWest
Size of Parcel 1 Zone Classification
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation (Building Area in Sq. Ft.
ZI P
Main Floor
Upper Floors 1 Garage Area
Storage
6.
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
8.
DESpRIBE WORK
v
IgfOTHERY
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
R
eq'd.
Rec'd. Not Req'd.
Enum. Dist.
ILocation (Area)
ION
9.
SOURCE GAS ELECTRIC
OF
UTILITIES
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
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
SPECIAL APPROVALS
NAME DATE
SIGNATURE OF APPLICANT
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
boy ,7"7-
02*
99 t5
02* *47.00
*L.7,006
*000 J
949. U.
09-26-83
6,!79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
26 83 9.49.5"z
09*42,OOa-12 _
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL