1981, 12-04 Permit: 81B-2448 Fire Damage RepairPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
u APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
tq, X21 Li9,er-NAC., LEGAL DESCRIPTION —SEE ATTACHED
LOT I BLOCK ISUBDIVISION PARCEL NUMBER/S CDQ(akfo IMOD .,U 6a6a,--4X PC)
2' (J 0 L.01 I -1I 2)LIC%5 1 i�'i 14 (1 EXL.
OWNER U /y\ PHONE QL.`I IS'., AIJ— LU -T'2 --Lo A.
3. 1 ELj—
ADD�RjESS
ZIP
Actual Set Backs in Feet
s
North Isouth East West
C TRACTOR
PHONE
Size of Parcel
Zone Classification
�N)LD IZtJ"DR` f21.1G7�Gs�
�'� �
4.
ADDRESS
Z P
Type
Sprinklered
_
L.. 7I1 ``3r t
+Const.O!c�cupancy
Li.N
--:5
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valluation
Building Area in Sq. Ft.
5. ADDRESS
CHANGE OF USE FROM
6.
ZIP Main Floor Upper Floors I Garage Area Storage
Area of Decks I Finished Basement I Unfin. Baseme
No. Baths No. Stories
TYPE ❑ NEW ❑ ALT. ❑ AD'N. RPL. ❑ MVE.
7. OF ❑OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK Enum. Dist, I Location (Area)
8. RCi'- i4 illt VI QL
VALUATION1 SOURCE GAS ELECTRIC I WATER SEWERUSE CODE
OF Ownership
UTILITIES Public El Private
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 SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS: 66Nr� 1 �ai2
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
,Bdilding_Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF' ISSUANCE
No. Rooms INo. of Dwellings
teq'd. I Recd. Not �'eq'd.
FEES COLLECTED
Single $
Building W�e • «%
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ (j(,0.c>eo
PERMIT NUMBER
0(C3 -- 2441g I
� * *11600
Wi ;! :0 s,
*11F00 1c, 51
A * n
2447.'
1 _-04—h I
479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
8, 1, 24482 *116.00n°�
DATE ISSUED PERMIT NO. TOTAL