1981, 04-17 Permit: 81A-3650 MHPLAN 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/ADORES$, . /j • O/�y�f-
' LOY I `BLOCK BDIV I N
eL
2. 3 I ,/
SU IS O
13.44424-Je a.t 7r{.1.0,.91.,t /4t add .
PHONE
9z4-6g/z
LEGAL DESCRIPTION — SEE ATTACHED
3. ({ItiI�G(
ADDRESS 1 �j
& /9/z0 -241,4-40#. t. (9%cw akrify do
CONTRACTOR
a. stail•
1/t
A DRESS
DESIGNER
PARCEL NUMBER/S Q SSJ „, _/243
£O7 3 ,(3,CK-
BAR K R ROAD Mea/.45 Hvvi.E /srAion
5.
ZIP
920,27
PHONE
Actual Set Backs in Feet
North 8'1 / 'South ie
ZIP
/
East S West.5"
Size of Parcel
70X /7
Type Const. Occupancy
i -N R-3
Zone Classification
41,4. �L/O/JJ/.a saCi
Sprinklered
❑Yes ❑No 0 Req'd.,
PHONE
Valuation AA
,3g61
Building Area In Sq. Ft.
% 8d /.L.E /ion
ADDRESS
ZIP
Main Floor
780 /
Upper Floors
M0�5
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
TYPE ® NEW
7. OF
WORK 0 BLD.
O ALT.
O PLMB.
❑ AD N. 0 RPL. 0 MVE.
❑ MECH. RI' M.H. 0 POOL
0 OTHER
Area of Decks
,/�,(r^�f{�'tc inisheo B
No. Baths No. SSt es
1 /
ement
Unfin. Basement
CERTIFICATE
of EXEMPTION
No. Rooms
Req
No. Of Dwellings
Reed.
Not Req'd.
DESCRIBE WORK�
B. 711A I?JJ "l�,i-yCsl�a n_,RQ,OG/�i.. a- (/ZX /, T
VALUATION I ELECTRIC, WATER
22
3/S DD
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 REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 'Y'/—/ 7—?/ SIGNATURE OF APPLICANT.4.LL/r
SOURCE GAS
UTILLIITIES
SEWER
Enum. Dist.
Location (Area)
Ownership
Public 0 Private IQI
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
—T L1)�} 47
Fire Marshall
esAzfrcii J2w
Co. Engineer
.R il�.L4t. E-- E(/sr,na
OR/ vWwgy
C 44[3 curs
CILAc/c TOP
'-,t '—
UtZlilies /
Plans Examiner
SEPA Checklist
Buil ing Tec nicia —t
PERMIT IS NONTRANSFERABLE
USE CODE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
p
H e
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
'SSD �•
Other (Specify)
TOTAL
$
�PEFii. N IF:EER - `
st k " 56,* 0
03* *9.00
*9.00 173
49.0;0,5
A *Q00
3;64;82.
r. 04;-17-81
.2 6 4.7 9.
0;1'4,.• *5Q00
*50.0,0 fin
364.;9'2
04-17'-8±1
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,I4'r X117'111
17'1 e'0 ,11
DATE.ISSUED
UU LL
6; 1 c
PERMIT NO.
*'5'90.0ag -
TOTAL
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III
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5%
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