1981, 11-12 Permit: 81B-1740 ResidencePLAN NUMBER
4c/fIS/f
APPLICATION/PERMIT
SPOKANE COUNTY WILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
4cQo.
LEGALDESCRIPTION — SEE ATTACHED
LOT
2..
OWNER
BLOCK
2
SUBDIVISION
SLANNNtl0.Le.. Acnes
3. G.A. 4?Aave-/
4.
5.
PHONE
a�Lo-. x7g
PARCEL NUMBER/5
Ol64 i-1301
ADDRISS
N.4o3_1 'Ar24‘)S
CONTCZACTOR
A I3LA(LoERS
ADDRESS
R.O. Box _16ca' -
DESIGNER
ZIP
Ctet'2/0
Actual Set Backs In Feet
North.2.027K (South sot 1East 4-0
(West as .a6.
PHONE
443-t-'7‘39
ZIP
442.03
Size of Parcel
X50 X.9—AS
Type Const.
Occupancy
R.3/m-7
Zone Classification
S,NCu_E FArnu-q
Sprinklered
Dyes 0No 0 Req'd.
PHONE
ADDRESS
ZIP
Valuation
7&&t4 -
Upper Floors
1 Main Floor
`gc05
Building Area in Sq. Ft.
1.S' -tel
Garage Area
5(o4
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfits. Basement
1?2.S '
TYPE
7. OF
WORK
11 NEW
LJ BLD.
O ALT.
❑ PLMB.
O AD N.
O MECH.
❑ RPL.
D M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
2.5
No. Stories
No. Rooms
1
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not j[eq'd.
DESCRIBE WORK
8•StNCiC,4.tAwllt-4 RS. cs.,t 2
CAFR,E A•Tf14cMco
VALUATION SOURCE
O
s!1i/cd7) UTILLITIES
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 con truction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION „t 19..-51,51
Enurn. Dist.
Location (Ar a)
GAS
ELECTRIC
WATER
SEWER
SE.azt1C
En
SIGNATURE OF APPLICANT /
SPECIAL APPROVALS SPECIAL CONDITIONS: C-0nJ-t. („ c. No
NAME .DATE
nn
Fire Marshall
/5erg4/
121111.1M
UtIIII les
Co
6 ,
Plans Ex- finer
SEPA Checklis
Buildin• Technlclan
1
i c —1
Ownership ,,.//
Public 0 Private tC
USE CODE
:48 t
0- ;.7 Mr
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 $-3Co4'-ce
PERMIT NUMER
02* *364,00
* 364.00 N
* 364006
A .*0.00 0
1053
1.0-23-81
A 64:79.
WHEN MACHINE VALIDATED IN THIS SPACE, ,
THIS BECOMES A PERMIT.
7IM!:i!2'b'8/11
DATE ISSUED
1'7'.40'5*•36400ae_
PERMIT NO. TOTAL
ICLohAL
5-r — U
Nes:- r1: r 1P -
I, ALgF3 4rm,oH
F1/4•T.arp jc•
/ 9%;z/C
924-51,z?r
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