1981, 01-29 Permit: 81A-1009 DuplexYLHIV IV UIVI CStK - . APPLICATION/PERMIT Yt-KMr. r U LK
SPOKANE COUNTY - BUILDING CODES DEPARTMENT et Pt r 111 ob Cl
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
ADDRESS
JOB ADDRESS
` ��+� y 1719,
Q Lal
K<LEGAL
arage Area
DESCRIPTION - SEE ATTACHED
CHANGE OF USE FROM
TO
I BLOCK
SUBOIVISION0
Basement
r
6.
PARCEL NUMBER/S�� P�
2LtYT
l
Cu�{
Aoyrll
No. aths
No. Stories
No. Rooms
OWNER
,�f
TYPE Lte7 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
PHONE
7, OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
3.
WORK lj1/BLD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
of EXEMPTION
�/
ADDRESS
ZIP //
Actual Set Backs in Feet
OF
9. UTILITIES Public ❑Private
Single $
c <w
North South 10
East West ✓ ✓
to give authority to violate or cancel the provisions of any other state or cal law regulating cons ion or the
CONTRAC O 11
performance of construction. E REVERSE SIDE FOR REQUIRED INSRECTUONS
Plumbing
PHONE
Size of Parcel
Zone Iassification
SPECIAL APPROVAL SPECIAL CONDITIONS:
NAME DATE
0 0
1 H UvrI
4.
ADDRESS
ZIPType
oust. F;pancy
Sprinklered
Mobile Home
Fire Marshall
�K41 1
❑Yes ❑No ❑ Req'd.
Other (Specify)
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
�71
5
ADDRESS
ZIP
Main F oor
I Upper Floors
arage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks .
Finished
Basement
Unfin. Basement
6.
IJI.I�v
l
No. aths
No. Stories
No. Rooms
No. of Dwelling
,�f
TYPE Lte7 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not F�q'd
WORK lj1/BLD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
of EXEMPTION
�/
DESCRI E WORK Enum. Dist. Location (Area)
FEES COLLECTED
8 Q
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑Private
Single $
1 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 Building
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 cal law regulating cons ion or the
performance of construction. E REVERSE SIDE FOR REQUIRED INSRECTUONS
Plumbing
DATE OF APPLICATION % SIGNATURE OF APPLI ►
Mech.
SPECIAL APPROVAL SPECIAL CONDITIONS:
NAME DATE
Plan Check
En H I
SEPA
Planning
Mobile Home
Fire Marshall
Co-EnaiNer ✓' `Z-
Other (Specify)
Plans txaminer
,i2* *"4900
n n
*_7490016
1 00.42
01-29-81
t 6,479
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE 0'1'-�'9 -8'1 10021 *3 4'9.0 0 a �
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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