1981, 10-22 Permit: 81B-976 SidingPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
v/
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3•COPIES"
JOB ADDRESS
1.
LOT
2. 11
ID BLO kK° SUBDIVISION .
butit
. LEGAL DESCRIPTION - SEE ATTACHED
hMpgMrtitd'I�, Fj. r3 nt'jQ.
OWNER
3. LOP rha,,r Po+erson
ADDRESS
0(007 E. mom cudL
CONTRACTOR
hio,Urf , PWC {-hQxs Cnvvt
D .
4' AD ESS
fO, 3lo(0. Ar1nhnn jd
DESIGNER
5' ADDRESS
Tor-
glo9to
PARCEL NUMBER/S I / r4 - oil
z4q anti,
Actual Set Backs In Feet
North (South East 'West
PHONE
qts'-46AG
Size of Parcel Zone Classification
ZIP
agao,,
Type Const.
Occupancy Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage •
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Untin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
O PLMB.
❑ AD N.
❑ MECH
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
OTHER
No. Baths
No. Stories
.,No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Redid.
Recd.
Not Req'd.
8.
DESCRIBE WORK
Si
9J2j St4A.L
Enum. Dist.
Location (Area)
VALUATION
9. Iagnioo
SOURCE
OF
UTILITIES
GAS
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 REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION zeyWri SIGNATURE OF APPLICANT y r�
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planntng .
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
g
ste
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
3a 4rT
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 3a770:07;--
PERMIT
a G°
PERMIT NUMBER
2l -979
02* *3200
*3200 '
*32006
A *000
97.5 p
10-22-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• 1Y13112422.1'-'811.
1 • '!' ('
• '11
` 1311242Zj':'8i. 976 Z
DATE ISSUED PERMIT NO.
.2.'0 0'2 1-
TOTAL