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1981, 03-13 Permit: 81A-2394 ResidencePLAN NUMBER -. . I- 5/41-/7 30/e/ 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 rJ B ADDRESS / 1. Il•op) MoF<t Roh)c' 1 I BLOCK SUlAVISI 2. rc, cal y i4fT A00, ADR S Yi - r✓ K.o VV/ . f G^ ZIP_ LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S 07 5-�,t o I Actual Set Backs in Feet North !/ ISouth_.7 East (west 2.30 CONT ACTOR I 4. 711ArcN ADDRESS �50r, &. s Ono Pmt' DESrGNER 5' ADORES"* PPHHON (,/�0! Size of rcel I b y4 17 -0 - Zone Classification °Aril al M411 • O 6 T pip Const. Occup ncy 57, Sprinklered ❑Yes ❑No 0 Req'd. PHONE ZIP Valuation CHANGE OF USE FROM 6. TO Iain Floor Area Decks Upper Floors Building Area In Sq. Ft. Garage Area �� Storage ,5?2- Finished Basement Ugfin. Basement II 4--4- TYPE 7. OF WORK INEW cf/NBLD. O ALT. ❑ PLMB. ❑ ADN. 0 RPL. ❑MVE. ❑ MECH. 0 M.H. ❑ POOL 0 OTHER No. Baths No. Stories i2 - No, pooms No. of gwellings CERTIFICATE of EXEMPTION Req'd. Recd. NNotyzed. DESCRIBIE WORK 8. eiNGEGjI20 VALUATION 9. FAO iv? Enum. Dist. I Location (Ar al SOURCE OF UTILITIES GAS ELECTRIC WgTER SEW' 4,0'11°tfJ/(R-I{11 'G Ownership USE CODE Public ❑ Private. 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 pr not. The granting of a permit does /jot presume to give authority to violate or cancel the provisions of any other state or local law regulating consyf/}ction or the performance of construc ion. SEE REVERSEQSIDE FOR REQUIRED INSPECTIONS DATE OF APPLICATION •Mh �• C-1. (,1 SIGNATURE OF APPLICANT�j��-� SPECIAL APPROVALS SPECIAL CONDIT ONS: rip NAME DATE IFINkr LAC. 24 -Z --o I - PJ -' II s: KZ " ///%i Env Planning Fire Marshall o. Engineer c4i7rf -03 Utilities Plans Examiner Tom- rl SEPA Checklist PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ .?(oceo PERMIT NUMBERatiliallI ate ��- 02* *29800 •*29800 4 '*2980.06 A *000 S 2202 A 03'=09-81 2 6479. WHEN WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 0!31!13i;t 2f) 9.41 Al2.9: 0:.0 DATE ISSUED PERMIT NO. TOTAL Lri aS�pl I'�7 N1 -17 -al S • FI ES 1slu. P4 oriec-1--%pr -1- P N r zao cttJgflCL D 5141,1e�.4t�EP;flLa-4 r1Ct5D.l.