1981, 09-29 Permit: 81A-9941 Pole BldgPLAN NUIEg (�
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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
1.
2.
JOB�DORESSS
LO ,
BLOCK DDIVISION
Geww.ti (Qeeehr.Su6 S3 TaS JE /V
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWyy ER
ffnloetu1 SK/AJ.vtl2.
PHONE
PARCEL NUMBER/S
O3Sy/-3Y6/
ADDRESS
r /3V07 Etay
C {JTRACTO/RR�
4. A Aa �,G7/c�0$
7Pce?Ax163/5
y Fad
Actual Set Backs In Feet
North S (South 0 East /0 (West .5.-/
PHON
1a,3S7
Size of Parcel 6X As- Zone Classification
c 7S/3creeS G. . Su -wU
5.
DESIGNER
j70. 7
PHONE
Type Const.
Occupancy
intt-‘
Sprinklered
Oyes ONo 0 Req'd.
Valuation
Building Area in Sq. Ft.
/a0-0
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
/4.2 010
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
;]4V EW
XBLD.
0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
NoBaths
No. Stories
No- Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Nor.
DESC F W043
0,! C 406- Alo SLf4-/.9
Enum. Dist.
Location (Area)
'b." V ALUATION
9974
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
Sera/1C 'SE�W�E R
SCK ,-t C
Ownership tvl, USE CODE
Public 0 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:
NAME DATE
Env. Health
P
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklis
vr4- °O --a) lNG Csvz)lcln.v--)
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
SO. W
PERMIT NIf ASER
gi41
02*
*5000
*50.00
*50006*
A *000 0
.98712
0:9'25-8
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11.21 I II I
DATE ISSUED PERMIT NO. TOTAL
99;41= *5.00020
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0
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I 1 I PROPOSE° L
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1 X 10^ 1 ' 30� x 40 �
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QI ,,\ •t,rc , F BUJ LDIIIG
1 I
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SINGLE STORY
IORI VEV/Ay
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HOUSE
( EX l s T /NCi)
II
f
PROPERTY LINE
4?,
1 BLAKE n/An EA/t
CL4RE ED&E,
IF it t4/ E
EVER EXTENDt:
J
DEAD END
-et-
4- HER0Y -�
CONCRETE CuRB
(Lx 15T/N6)
ASPHALT
AND CURB
EPJb
1 PROPOSED PLOT PLAN
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