1981, 09-29 Permit: 81A-9939 AdditionPN NLLJMBER
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. T% /509 Locus, -,en
2 LOT SUBDIVISION Oit Id
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
OWN
3 H/t/P eLe ez�/Co0C.
ADDRESS 69 /„ eaa.7-- A
PHONE
47e729 -L37079
PARCELNUMBER/S 1 �i�,l
4. 70 I a • 7'Z'YI2o' q C I -r71
-11?... 17
CON ACTOR nn
i 1 DauXE' veMainIG-
4' AD 1
�ESSD e J7o 7
PHONE ,p
irt
4W--7/ 70ona
Actual Set Backs in .Feet
North South
Size of Parcel
G7 x 70
East 'West
ZopeeClassification
C/OCC I . 5 L.l ✓
5.
DESIGNER
zk197.20
PHONE
Ta Cpnst.
O tipancy
3
Sprinklered
❑Ves ❑No 0 Req'd.
Valuation301 - IBulltling a In Sq. Ft.
at -
ADDRESS
ZIP
Main F or
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
1%BLD.
DESCRIBE WORK
8. R7oc
VALUATION
9.
❑ ALT. i 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
R eq'd.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
arriCr
Ownership
Public 0 Private
/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 cons,. ction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
&
DATE OF APPLICATION 9 III22ga� SIGNATURE OF APPLICANT St. . A -0L12 -i--"'
SPECIAL APPROVALS SPECIAL CONDITIONS
Env. Health
37a • c172s$)
Planning
NAME DATE /,141 LAC _ (c -,R -et 3f Ij )
Fire Marshall
Co. Engineer
Utilities
Plans amen r
GL•
E klis
Buil ing echniclan
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Fjd1'd.
FEES COLLECTED
Single/(($
Building i I
Plumbing
Mech. -
Plan Check
SEPA
Mobile Horne
Other (Specify)
4
TOTAL $
PERMI NUaER
SIR -41013°1
02* *4400
*4400 65
*44006
A *00.0 a
9'8422
0.9'= 2 5*- 81
3 6479.
1
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.0�9i:44?19I 8„1'
DATE ISSUED
99192 .*4.4:01OaIJ-
PERMIT NO. TOTAL
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