1981, 04-10 Permit: 81A-3363 ResidencePLAN NUMBER - 4' -,
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APPLICATION7PERMIT
SPOKANE COUNTY BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3•COPIES
2.
J0d3 ADDRESS If%t-OCK LOT.
I
Mole ccriyT
3
OWNER m, 4 . GIM IV
SUBDIVISIONI
c-1 psc4 S N JL5-<, of f. -(0 glen�t�.
PHON
2. -123,56
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 0-75'4 ' ✓
C2)
ADDRESS
"30 6.* 01a4A40146CC12
ZIP
920
Actual Set Backs in Feet
North (South 2-0
East IV/est +3
CONTRACT .6
4. ADDRESS
DESIGNER
5.
PHONE
Size of parcel
191 x 1,-o.
Zone Classification
'.114‘�Lb t
ZIP
T
Const.
ccupanq
I
Sprinklered
❑Ves ❑No ❑ Req'd.
PHONE
Valq�t5op
Building II 22 fps Ft.
ADDRESS
ZIP
Main 5lopr
la
Upper Floors Gauge Area
2-S
Storage
CHANGE OF USE FROM
6.
TO
Are of Decks
Finished Basement
U nfin. Basement
TYPE
7. OF
WORK
,i EW 0 ALT:
LJ BLD. 0 PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
0 MVE.
❑ POOL
0 OTHER
No. Berths
No. Stories
No. Rooms
No. of gwellIngs
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not R .
8.
DESCRIBE 'JORK i4 N(/
V,A�IL�UA�tTIT�IIO✓✓NIV^SOO SOURCE O'AS RIC
9754(240 OF
`J� OF
Enum. Dist.
Location (Area)
ATER
G �
SEWER
Ownership
Public 0 Private
7OSE 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 presum
to give authority to violate or cancel the provisions of any other state or local law regulating construction or, e
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
1• NT
corJ,�-1�' `SI -M� P-' - 14231 Kz) 5 9/81
°e- 4/% /rrR oo D pL',j-5 drJ � s
DATE OF APPLICATION(n f [g'' • s) SIGNATURE OF APPL
SPECIAL APPROVALS
1 NAME DATE SPECIAL CO DITIONS:
En . Ueatth
Planning
Fire Marshall
C En eer !/V
III l
Plans Examiner
.1\14- <csAv.
SEPA Checklist
Bu a- nlciaj0
Wit
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
ec .
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ ZelL o0
PERMIT NUMBER
StA-33�3
02* *298.00 '
*29800 rti
*298008
A *0.00
3:2128'2
04-08=81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
:;1110r_ii8,;i<
,4i
DATE ISSUED
313'&3!z *2:918..0 O.D2,!
TOTAL
PERMIT NO.
0
U
J
Mase
yw%
101
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'tc:54:4dI
12
52
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