1981, 09-28 Permit: 81A-9877 AdditionPLAN N'1t)MBER
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
3.
4.
NN 4 Lit.] ask 4Hfl 1
DRESS/1
2,1
CONTR jOa
0' A cojJ5-f-
ADDRESS
7-&17, t)150441 MQ
".2J 777
"7-4042
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 49t / 3 09 2
rot,,,3 G. it7 LAG,- 5, 231 4t 5 V5 op Ali/2
Actual Set Backs in Feet
North 'South [East 'West
P ONE
�-3/13
Z,/ -OG
Size of r 1
Type c
n st.
Ot pancy
Ali
Zlassification
SLG.
Sprinklered
❑Ves ONo 0 Req'd.
5.
DESIGNER
PHONE
Valuatgap
23�7O
Buildi rea in Sq. Ft.
ADDRESS
ZIP
Maip Floor
Upper Floors.' Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Are of Decks
Finished Basement
Untin. Basement
❑. 2EW 0 ALT. Cl AD N. 0 RPL. 0 MVE.
1?! BLD. 0 PLMB. 0 MECH. ' 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Recite!.
Recd.
Not ijGq'd.
DES RIBWORK1I
8. KIrfj1 ne ?v00IT ('5 x
Enum. Dist.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
�L r(ICJ
Ownership
Public 0 Private
Location (Area)
governing this
s not presume
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
type of work will be complied with whether specified herein or not. The granting of a permit doe
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
9 -
SIGNATURE OF APPLICANT
SNAME DATE CIAL APPROVALS SPECIAL DONDITIO : -2;2
�
C-01\11,OI11 C- rC.{�'t/+ — `2OrFC7 v
En
Ing
Fire Marshall
Co. Englnee
Utilities
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
st
PE:+. IT UMBER
a I A - a8?i1
02* *4'400
*44.00 1,3
*44.006
A *000 3
96862
09=23'81
.2 6 4 7'9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
9.8'7, 7 1 *,4.11'0 10
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL