1981, 02-18 Permit: 81A-1572 Complete ResidenceN NUMBER / APPLICATION/PERMIT PERMIT NUMdER_��
SPOKANE COUNTY BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. A
LEGAL DESCRIPTION - SEE ATTACHED
L T I BLOCK ISUBDIVISIPN PARCEL NUMBER/5
c /—oo �
2. � I 1/ %� 1-07- S 61— l Na1eP11AirENS ADD
OWNER
PHONE
Main Floor
3.
Garage Area
Storage
A
ZIP
Actual Set Backs in Feet
I
7
North South
East West
C TRACTOR
PHONE
Size of Parcel Zone Classification
i
Finished Basement
Unfin.. Basement
k
4.
ADDRESS
ZIP
Type Const.
Occupancy
ISprinklered
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. MVE.
No. Baths
/
_
—_,
I
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
V
V luation
0--'
Building Area/in Sq. Ft.
z o00
9,Il0
* X�ZC0
1 7. 1 r=
y E 479
5' ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
—
I
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin.. Basement
6.
1
1 17(pD ,
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. MVE.
No. Baths
/
No. Stories
No. Rooms
C�
No. of Dwellings
OTHER
7, OFl�
CERTIFICATE
Req'd.
Recd.
Not Req'd.
BLD. PLMB. MECH. M.H. POOL
Yw El
WORK
of EXEMPTION
I
DESCRIB WORK
n . -r ' D D 11 A _
Enum. Dist.
I Location (Area)
FEES COLLECTED
8.
VALUATIONSOURCE I GAS ELECThIC WATER SEWER
Ownership USE CODE
UTILITIES Public ❑ Private Qa
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions ijuded
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governgtype of work will be compliedwith whether specified herein or not. The granting of a permit does not to give authority to violate or cancel the provisions of any other state or local law regulating constructioperformance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTI NS ng
DATE OF APPLICATIONa"I SIGNATURE OF APPLICANT i
SPECIAL APPROVALS
NAME DATE
rianning
Fire Marshall
neer
ns Examiner
uil ing Tech
SPECIAL
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ s
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 -2 5 Z2 z
*3200 -