1981, 03-30 Permit: 81A-2874 AdditionPLAN NUMBER
%$/A 12% 373v/g/
t,
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (609) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS,Is 4-0 3 V(,�
LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION
2. Z cfi,e,ex 4 0r cFI r,.s I P-SI:a.jV/I C'1ri�Ot NE -4061 j
OWNE�1614/6k l JilT� l`1 ��(JE-4061
�ruJ/�I I
COigNT Rfilc
PHONE
3.
ADDRESS
�• 1340 .4E1�jo{
ADDRESS
ZIP
PARCEL NUMBER/S 03154-1
— -2)9n 2—
Actual Set Backs in Feet
North ISouth�� [East 10 (West
Size of Parcel
DESIGNER
PHONE
Tyye Const Occup ncy�
i .,iv
Valuation
r7 -0o
Main +Il Or Upper Floors
Ce
ADDRESS
ZIP
Zone
lassiflcati n
rotN�l L�1'
Sprinklered
Dyes ❑No 0 Req'd.
Building Area in Sq. Ft.
Garage Area
4 Q
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basemen
Unfin. Basement
TYPE„,
11 W
7. OF_
WORK BLD.
❑ ALT.
❑ PLMB.
EA N.
0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Bath
No. Stories
a
No. Room
No. o/ Dwellings -
CERTIFICATE
of EXEMPTION
Req'd
Re 'd.
NOt FjB(1'd.
DESCRIBE WORK
8. /%17412
'I'JrilolJ (2 CO X 3 2)
Enum_ DIst.
Location (Ar a)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS ELECTRIC
WATER SEWER
k41 IM4100 G
Ownership
Public 0 Private
SE 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 INSPECTION
DATE OF APPLICATION 3 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
En Ith -3/��
Planning
Fire Marshall
Co. Enginee
Utilities
PI ns Examine
• SEPA eccst""—
Ing Tecgj Ian
SPECIAL CONDITIONS:
SM -1S-3 / /4,1“-74- /,tc61-11
12€s--rL¢/
fZAALc ritr Jnvn..
/7A4/«.o G,' /2.,.._74 i/sI
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
o O
TOTAL $ 16/41r—
PERMIT NUMBER' • 4...11•1
g/A
03* *140.0.0
'* 1 4 0.0.0 to -
*1 40.006
A. *000
. 2762
03`1-25.-8.1
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0:314
leilN8ii11
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE - DATE ISSUED
28'Z4= *1:40.,0,02J -
PERMIT NO.' TOTAL
w
0
(
0
121=0"
ptidr• c. ow E 11
J
Elan
J4EW rcUON
(6mie.s- vrlat. t+1YHlk)
4LP114. 7[j►►71(
- 2.,710"
t2,5V
nr or.
• /• A
•
-' • )2 1 =SRX; ;• `,� ,i`s
,r •Y. aC'c. •
•
LAN
••T•
ND_GAtr
• w
.�
•
�.c. • , i
r'
tlr