1981, 10-12 Permit: 81B-591 Repair Fire DamagePLAN 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
JOB ADDRESS
-*Ate.
LEGAL DESCRIPTION - SEE ATTACHED
LO
2535¢
BLOCK
SU
Fratrwfl1c5
3
4.
OWNER
�RTfZ�Lk
ADDRESS
E. liteS
CONTRACTOR
Noeme, t3F
ADDRESS
f.4 .
�i ac,it t_3r n/V_
YY1 A Q /CET
PHONE
ZIP
QQ ? eC,
PHONE
43 -64-74-
ZIP
c2.a120-,
PARCEL NUMBER/5
OGS 2 0747
Actual Set Backs in Feet__
L��Ttly
l
North South E lEast
Size of Parcel
'West
Zone Classification
Type Const.
Occupancy
P.3
Sprinklered
Oyes ONo 0 Recite].
5.
DESIGNER
PHONE
ADDRESS
ZIP
Va abon
•IL36a
Main Floor
Building Area in Sq. Ft.
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
O NEW
gB LD.
O ALT.
O PLMB.
O AD N.
O MECH.
00 RPL. 0 MVE.
0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
'of EXEMPTION
Req'd.
Reed.
N of Req'd.
DESCRIBE WORK
8- Re5erkt
IA VALUATION SOURCE GAS ELECTRIC
7300 OF
UTILITIES
Enum. Dist.
Location (Area)
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 local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION (L — �? — � SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Ut i b t l es
Plans Examiner
SEPA Checklist
Bu i idin. Technician
SPECIAL CONDITIONS:
-REP, 4!
1`Zc/ vv PCL -L
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building L9 -'2L .08
Plumbing
Mech.
.Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 0.2,00
PERMIT NUMBER
0.2* *2200
* zz.uu
* 22008
A *000
'59.08
10-12-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
•
5'9,15• *2200 J
PERMIT NO. TOTAL