1981, 01-29 Permit: 81A-1007 DuplexLHIV IVUMLitK -
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APPLICATION/ PERMIT
Upper Floors
-4
R�
/
SPOKANE COUNTY — BUDDING CODES DEPARTMENT
"-
CHANGE OF USE FROM
TO
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
Finished Basement
APPLICANT: COMPLETE NUMBERED SPACES - PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
1•
. I7ZI-Z3
Gt.ENN
No. Baths
No. Stories
No. Rooms
LOT
BLOCK
4
,
PARCEL NUMBER/S
2.
(p I
1
ISUBDIVISION
sal Z
P -ft -
CERTIFICATE
OWNER
Req'd. I Recd.
PHONE
qzs
3
of EXEMPTION
54.3-1
ADDRESS
Enum. Dist.
Location (Area)
ZIP
Actual Set Backs in Feet
• O
^
on-.
Q
North 3!5 ' South 1 011 East � West 14111
S
CONTRACTOR
WATER
SEWER
PHONE
Size of Parcel
Zone Classification
OOS
UTILITIES
S�
IVI" .-T % , i
4.
ADDRESS
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
ZIP
Const.
Occupancy
Sprinklered
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
-Type
T
Q 3Ir,,%A
❑Yes ❑No ❑ Req'd.
DESIGNER
Mech.
PHONE
Valuation
Building Area in Sq. Ft.
5.
1
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
"-
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE _/
No. Baths
No. Stories
No. Rooms
No. of Dwellings
LJ NEW 1:1ALT. ElAD'N. ❑ RPL. ❑ MVE.
4
,
•Z
7, OF ❑ OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd. I Recd.
Not Req'd.
V
of EXEMPTION
DESCRIBE WORK
'
Enum. Dist.
Location (Area)
FEES COLLECTEDU
8. �c=g)4 G" �t Q
VALUATION
SbjCE
S
ELECTRIC
WATER
SEWER
Ownership USE CODE
OOS
UTILITIES
S�
Public ❑Private
Single
$
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
%7�•yo
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEES REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
` — 8�
Mech.
DATE OF APPLICATION ` J SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
wyI
02�
Planning
Fire Marshall
TM
Utl tis
Pans Examiner
SEPA Checklist
Building Technician _
SPECIAL CONDITIONS: I-fok&'a2-
Ei4 ' -N-1 A) fb N A'�P'=o y •� L 0n1 T: W^ P6 yRT&-
rl-
A
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
02* *34900
*34900
* [t900Y
A *C 0�
1 CO,b:c
Oi-29" 81
6479
TOTAL $ -
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
OIl;�;.gz8l 10Q75 *34'9.00a�
DATE ISSUED PERMIT NO. TOTAL
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