1981, 05-27 Permit: 81A-5129 ACPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING C.ODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
5.
JOB ADDRESS -
LOT 1 BLOCK
OWN
L7 7,-zz
SUB ON
ADD6 ESS t /4?) �r Lied
CONT CTOR
O 376 7
LEGAL DESCRIPTION - SEE ATTACHED
E4/,, 6(;\
/
PHONE-s.L0
%-/6/�70
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South LEast 'West
Size of Parcel 1 Zone Classification
DESIGNER
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes Ohio 0 Req'd.
Valuation 1 Building Area in Sq. Ft.
ADDRESS
21 P
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfln. Basement
TYPE
7. OF
WORK
r/ NEW
❑ BLD.
O ALT. 0 AD N. 0 RPL. 0 MVE.
O PLMB. ,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.
8.
DESCRIBE W K
VALUATION SOURCE I GAS
OF
9. UTILITIES
Enum. Dist. I Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 0
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 Ioca law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPEC/ONS
DATE OF APPLICATION SIGNATURE OF APPLI
SPECIAL APPROVALS
NAME DATE
Env. Healt
fanning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
dingle duan
V
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing ,[�//
nit / F Ue
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
ora
PERMIT NUMBER
btck
04* *14.00
* 1400
* 14.006
A *00.0 8
51282
05'-27=8,1
B 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
;asz��' 's,iI
DATE ISSUED .,PERMIT NO. TOTAL
5110'g, *140'0,°2