1981, 01-27 Permit: 81A-853 RemodelPLAN NUMBER
JOB ADDRESS
OYNER
3. — 3 -::i �
DDRESS
s^
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
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISIONPARCEL NUMBER/S Z,f4L�_ 2��
.(,a T3 L31 -1,C I1/—
PHONE JO#/V.5ro1v,5 3�il3 O/✓isio�
ZIP IActual Set Backs in Feet
North South East West
COTRACTOR
PHONE
Size of Parcel
Zone Classification
Z
4. AD RESS
ZIP
Type Const.
Occupancy
rSprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valwtion
o
Building Area in Sq. Ft.
/ �j
-,7,?'
5'
ADDRESS
ZIP
Main Floor
Upper Floors I
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
No. Baths
No.
Stories
No. Rooms
No. of Dwellings
TYPE 0,NEW Ik ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
—
7, OF ❑ OTHER
❑ BLD. ElPLMB. EIMECH. ElM.H. El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
L
I
1�
DESCRIBE WORK
-
Enum. Dist. Location (Area)
FEES COLLECTED
8 f.
ALUATJON
SOURCE GAS
ELECTRIC WATER
EWER
Ownership
USE CODE
9. �� !E I2
F
UTI LOITIES
Public ❑Private 141
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions includedaol
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
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
Plumbing
DATE OF APPLICATION Z — Zlo `9/ SIGNATURE OF APPLICANT 121 JZ/t.0
Mach.
SPECIAL APPROVALS
NAME DATE
nv. Health
Planning
Fire Marshall
o. Enqineer
Utilities
Plans Examiner
SPECIAL CONDITIONS: J�
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL r -
PERMIT NUMBER
s/,4
r�
/ _ 8i' i.l
*140,0
F5:2t'
i —27— ; 1
'' 9
WHEN
MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
j.iil/ly�ding Tech}}yyniciaJpJy �f PERMIT IS NONTRANSFERABLE
0,1 Z,.7 ,'8 '. 8 5. .3 z * 1' 0 Q. Q H