1981, 01-05 Permit: 81A-0015 MHPLAN NUMBER,
.1,
w. V
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
1. e /rgi2 c Qache ACE'7-
LOT BLOCK SUBDI I ION
2 COACH- Lire E5':.vres
LEGAL DESCRIPTION - SEE ATTACHED
2. /g
OWNER
3 4,eci//O Al4 r/V.c—'/es
ADDRESS
4-',/911/2 G.Q/!C•c e OT/S ,oetehoteas
PHONE
NON
ZIP
94027
PARCEL NUMBER/S a11s5` _ /3-45,
Lor /8 &[are 2
Actual Set Backs in Feet
North 317/ 'South b//
t3w64l-4/ EsmTE5
East 020 a 'West alai'
CRACTO R
4' A/ESS/T— 2/7-s //q %
SleSte /, Yff/2i oaz
DESIGNER
6. ADDRESS
PHONE
9a7/7/
Size tovAt //s. '
Zone Classification �/f�/,,�,���
/PES -%ate igrife
Z99v37
Type Const.
s—A/
Occupancy
R-3
Sprinklered
[hes 0No 0 Req'd.
PHONE
Va canon O
'77 3 80 oa
Building Area in Sq. Ft.
/4/4O/
ZIP
Main
/ami �n��Floor
/'7`f C%
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks Finished Basemen Unfin. Basernent
L& IIC .z4mt
t0
TYPE
7. OF
WORK
ad NEW
❑ BLD.
0 ALT. 0 AD N. 0 RPL. 0 MVE1
❑ PLMB. 0 MECH. %M.H. 0 POOL
❑ OTHER
No. Baths
No. Stories
/
No. Rooms
No. of Dwellings
•
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
DESCRIBE,lI/ OWO K
8. .IY.
JAL ATION
_Y/' OF Ownership
uP, a,41 %lac I &ca.( )
SEWER
Enum. Dist.
Location (Area)
�
P SOURCE GAS
9. ✓loe° UTILITIES ublic 0 Private j#
I hereby certify that I have read and examined this application and have read the ''NOTICE"
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 APP )CATION /2-3o- go SIGNATURE OF APPLICANT
EL CTRIC I WATER
USE CODE
SPECIAL APPROVALS
NAME DATE
Env/tea I to
Planning
i /2/3
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building /P/i€ Lnio. Qli14122Q1
SPECIAL CONDITIONS:
,A c7Trs"v�LL
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
X
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
gg—
Mobile Home JtJ/i
Other (Specify)
6
TOTAL $ /O0
PERAj1TiWNr,, ER
Stft-- -1
07* *100.00
410000 1
*100.1006
A *0.00
54082
12=31-18.0
z 6479.
/ow"'
0310
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 �
DATE ISSUED
i:51 8,1.1-0Q0,0al
PERMIT NO. TOTAL
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766((-9(11•Y,:,77,;•;xl."0„
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