1981, 07-31 Permit: 81A-7680 Re-RoofPLAN NUMBER
APPLICI'M ON/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
1.
2.
3.
JOB ADDRESS
E. 7815
LOT
BLOCK
SUBDIVISIbN
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
A.A.
ADDRESS
LI 8042:TY
E • 7815
S-TR�GkIF.�L
PHONE
4112-11"-- 72.6:7
ZIP
`19Zola
PARCEL NUMBER/S 0G5'113 — 33/3
Actual Set Backs in Feet
(South (East
North
'West
4.
CONTRACTOR
rc.
ADDRESS
PHONE
Size of Parcel
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
�JOV GD
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
O MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
HER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. New RK
LUATION
9.
01�
fid• is
If Of
SOU RCE
OF
UTILITIES
Enum. Dist.
PA/ 5?�►.ty S'TRU(.'TU� celMPCsli
I I 6wnership
GAS ELECTRIC WATER SEWER
ILocation (Area)
Public 0 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 .ermit does not presume
to give authority to violate or cancel the provisions of any other state or local law re ing ing construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPEC.. N
DATE OF APPLICATION SIGNATURE OF APPLI
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
DCDnIIIT CVDIDFC ((AIG VCAR CR(1M r1ATP (lC ISSI1AKICF
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
4)"
TOTAL $ _10
PERMIT NUMBER
8/A-76cP0
* 1 0 0-0
* 1 0 0 0
,670
0 7— 3 1 -- s0 1
7 9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01!-43 I = 8''1
rvATC ICC( Icr
7 6 & O Iz
DCR�AIT nix
*10,000.'
T C T A 1