1981, 11-06 Permit: 81B-1578 ReroofPLAN NUMBER APPLICATION/PERMIT
PERMIT NUMBER
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 ADDRESS0
LEGAL DESCRIPTION - SEE ATTACHED
* *
G 3 8.0 0
1. -5-, .�//
*38..00
LOT BISUBDIVISION PARCEL NUMBER/S
* 3 8.0 0
2.
OWK4R PHONE v�
1411eE/1 z- �0 ry 5�
A * C, J (J'
3.
ADQ`�ESS /'// Zlj� -ry Actual Set Backs in Feet
`�+ • '1 ,rT
1 ?, 7
North South East West
CO RACTOR _ PH NESize of Parcel Zone Classification
10200 1A,16Ae , -53
6479.
4' AD RESS /n( (/ Z
1'' Type Const. Occupancy Sprinklered
T 5r;Iv
1
0. 'J,ix -- / v ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5'
ADDRESS ZIP Main Floor I Upper Floors Garage Area Storage
_
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE❑ No. Baths No. Stories No. Rooms No. of Dwellings
NEW � ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK 1:1BLD. ❑ PLMB. 1-1MECH. ❑ M. H. ❑ POOL CERTIFICATE Req'd. I Recd. Not Req'd.
of EXEMPTION
D CRI E WORK Enum. Dist. Location (Area) FEES COLLECTED
8. /oat- MJ/7`A o
�
VALUATION SOURCE GAS ELECTRIC WATER SEWER
&��) Ownership USE CODE
�O Public 13 ❑
9. UTILOITIES Private
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included op
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances this 38
I
governing Building xx
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 INSPECT NS Plumbing
`
1�/— C�GtI Mech.
DATE OF APPLICATION SIGNATURE OF APPLICA `
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
ng Technician PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
.Mobile Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 h., - 0 6 - 8 l 15 Z 8 Z
DATF ISSHFn PFRrAIT Nn
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