1981, 04-14 Permit: 81A-3505 Siding, Soffit, FasciaPLAN NUMBER
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
JOB ADDRESS
1. NI 13o --I-Irra 5t
LOT BL CK BDIVISION
2.
OWNER
3 Sic I v,'�i bolti
AD ESS
1:)4 Locust
CONTRACTO
IY1e.Vtq &ofhvs nS/fors
4' ADDRESS p
AL 3/06 Ar- ()nal 4cca
DESIGNER
5.
PHONE
Ci -4.381
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
11542. - D?,D(a
ZIP
9t,10
Actual Set Backs in Feet
North -'South
East
west
2Y E 44., 4,
Size of Parcel
Zone Classification
ZIP
49aot
Type Const.
Occupancy
- Spnnklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfln. Basement
TYPE
7. OF
WORK
❑ NEW
0 BLD.
O ALT.
❑ PLMB.
❑ AD N.
0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DES BE WORK
8.di./1
9. 333 0a
7714044-/SbURGE
OF
UTILITIES
GAS
Enum. Dist.
Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private 0
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, regulating construction or the
performance of construction. SEE RE/VGERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 21//D/ O / SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engine,
Utilities
Plans Examiner
SEPA Checklist
Build' Tech
r
1
PERMIT IS NONTRANSFERAB
PERMIT EXPIRES ONE YEAR FROM DATE OSUANCE
FEES COLLECTED
Single
.Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
0+06
TOTAL $
x,00
PERMIT NUMBER
Cat p -35r
0.2 * *44.00
*44.00
• *44.0.06
A *000 8
35048
'04-.14-81
2 6'479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
P4-4il141t.8,1' .
1 35QZIl
DATE,ISSUED. PERMIT NO.
•
.1440.0.a.12. -
TOTAL
>-
0-
WHEN
-
2