1981, 04-24 Permit: 81A-3899 MHPLAN NUMBER
1/02 WI/ 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
t.T � _ le 7// CC r-eT
K ccS & T2 4 'VION
LEGAL DESCRIPTION - SEE ATTACHED
/�fC�AeN
2. �-L/7 as.. ,Zs
OWNER
3.
Eater G',eorr
PHONE
,(/o vE
PARCEL NUMBER/S FeRT- ogSi-2 —O/cJ9
Lor /4C Bcc1at 2 emeit/ir li
ADDRESS
G / f7// Ce -4e& tr
ZIP
x%027
Actual Set Backs In Feet
North (South
East
'West
4.
CONTRACTOR
CDAgN- Lire
ADDRESS
PHONE -
9 -717/
Size of Parcel
/3r/ /jca
Zone Classification
ite6. liosicr 44ra
ZIP
99eS 7
5.
DESIGNER
PHONE
ADDRESS ,
ZIP
Type Const. Occupancy
I/ -N P-3
V luation
I 3 ODo --
MainUFl0000r
/T
Spnnklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished
Basement
Unfin. Basement
TYPE
7. OF
WORK
✓ NEW
O BLD.
❑ ALT.
O PLM B.
❑ AD N. 0 RPL.
❑ MECH. rki M.H.
❑ MVE.
0 OTHER
❑POOL
No. Baths
No. Stories
No. Rooms
7
No. of Dwellings
CERTIFICATE
• of EXEMPTION
Req'd.
Rec'd-
Not Req'd.
DESCRIBE WORK
8. Noit & give
9.
VALUATION
SOURCE GAS
OF
UTILITIES
ELECTRIC
II WATER
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private
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
5
DATE OF APPLICATION 1 kaVie/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Awl
Planning
Fire Marshall
Co- Engineer
5I Ake 41
U ilities
Plans Examine
SEPA Check!
Building Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
9.°—°
/arc
$ /Aq. ccg
PERMITt UMpEi ' •
giA - 38 99/
03* • *9.00
*9.00 17)
*900'8
A *000
3:89.72
04'24-84
2 6479.
07* *10600
* 160.00 65 -
* 100006
A *000
389.'82
04-24-84
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Q (
DATE ISSUED
31a:9:94' *11191110 20
PERMIT NO. TOTAL