1981, 11-16 Permit: 81B-1869 Addition(PLAN 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 1-,� / r,s
LOT BLOCK SUBDIVI510
2. z4 �I� P�Z 0,24&. t 7[ —f Ac
3. Owisl,
AD.QRES$22' C ^`'/ N� l��
CONT AIT R
2
ADDRESS •
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S Q --7 — I 1•1a4-•
\ . 130or 5 1501 o P N • 155
4.
Z P
HONE
Actual Set Backs in Feet
North 'South
East
'West "t..)
Size of Parcel
130x I�ifa
Zong Classification
'-ply
ZIP
Ty a Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
ZIP
Va1uati n
Upper Floors
Main Floor
Building Area in Sq. Ft.
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
DitEw 0 ALT. El AD'N. 0 RPL. 0 MVE.
mai D. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
J
No. Rooms
No. of Dwellings
Req'd.
Rec'd.
Not f(eq'd.
DESCRIBE WORK
8.
VALUATION
9.
q -Vi o,
Enum. Dist.
Location (Area)
SOURCE
UTILF
ITIES
GAS
ELECTRIC
WATER
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 J,
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env(,Hh
Planning
Fire Marshall
Co. Engineer
Utilities
ns Examiner
SEP
_ :u`• Tech
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
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
$5(0
PERMIT NUMItER
St 3 --
*
*5600
0
1 7 5 4
11-12-81
6477
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1.1,4A 6 8 1�
18695 *56,00ai-' -
DATE ISSUED PERMIT NO.
TOTAL
r -,i. -o<. 24-
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