1981, 04-08 Permit: 81A-3247 ResidencePLMN NUMBER' ' t
• 2 frA-642 4//g/g/
y
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 ADDRESS
• I0
LOT
7
P LMm\ VtsQ
LEGAL DESCRIPTION — SEE ATTACHED
BLOLK
UBOI V ISION
I I “Ate'FR'110FJ
3.
4.
5.
OWNER 1t i� G • ( 1K G-"”)
PHONE
PARCEL NUMBER/S 0 t fi— I 7
ADDRESS 0 I0 4'
CONT�SA; ,I t
ADDRESS; a
DESIGNER
Z17 0Co
Actual Set Backs in Feet
North 'South % O (East
'West d
PHONE
Size of Parcel Zoge Classific
:21;tion,
o x Z f/tl! /�flJl
ZIP
Type Const.
Occupant
11ASpf lnklere15 '
Eyes ENo E Req'd.
PHONE
Valuation
7�Cazz15 °Ca
Building Area Ig Sq. Ft.
ADDRESS
ZIP
CHANGE OF USE FROM
6.
TO
TYPE
7. OF
WORK
,VVNTGW 0 ALT.
LJ BLD. 0 PLMB.
0 AD N. 0 RPL. 0 MVE.
0 MECH.' 0 M.H. 0 POOL
0 OTHER
Main Floor
j oCA
Area of Dfa 5 J
No. Bis N'oies
Upper Floors
Garage Area
,s4
Storage
Finished Basement
Unfln. Basement
No. Rooms No. of pwellings
(,o I
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
No[ geq'd.
DESCRIBE WORK
8. tilt E4I I LY IN G189,/\ -c) 4 OVA
VALVA ION SOURCE GA ELECTRIC 1 WATER
F
9. UTILITIES WINr
Enum. Dist.
Location (Area)
SEWER
Sr1C
Ownership
Public 0 Private IBJ/
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 , gulating construction or the
performance of construction.SEE REVRSRSE SIDE FOR REQUIRED INSPECT'
DATE OF APPLICATION
3
SPECIAL APPROVALS
NAME DATE
SIGNATURE OF APP 1_QAIQT
SPECIAL CONDITIONS:
'01\0 'AC -(G _ 6IR- rNj - m:11 4►j0 H/5/31
Planning
Fire Marshall
C
U
Plan
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE' YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
PIanCheck
SEPA
Mobile Home
Other (Specify)
$
3 2 -
TOTAL $
,bPERN•T NUMBER
Of-' 324-%'
0.2* *35200
*35200
*3520,06
A . *000 3
324.'6
01-08-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0;'Qjl'OjB;i�'•811r 324t71Z *3'"5200.2
DATE ISSUED PERMIT NO. TOTAL