1981, 08-21 Permit: 81A-8392 DeckPLAN NUMBER +,
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
JOB ADDRESS
�• e10.20
ie' eiohJ AJC
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2.I$5
OWNER
3.
BLOCK
SUB (VISION
�5-r jP.&-Ub7 JrOO.
t-ACo1.t'J
rlAw
PHONE
PARCELNUMBER/S 10 ff 0oILot- I 01
q? �l
t_0 1_0 -r5 tJ D. or 4 d-1^11 -
ADDRESS
tJD 20
4.
CONT RA CTO¢
,.1,SSloIJ
ZIP
%`)2-O (o
Actual Set Backs in Feet...
North South 1.l
Ea
IC" (West
PHONE
Size fPa�o
Parcel Zne Class' I�
/'V /v
ADDRESS
ZIP
Type Cons
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd
DESIGNER
5' ADDRESS
PHONE
Valuat
"7 O
Building Area in Sq. F
ZIP
Main Floo
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of ck; ,
Finished Basement
Unfin. Basemen
TYPE
7, OF
WORK
,d EW _ 0 ALT. 0 AD N.
lid BLD. 0 PLMB. 0 MECH.
O RPL.
O M.H.
❑ MVE.
o POOL
0 OTHER
No. Ba s
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not teq'd.
DESCRIBE WORK '' I
8. ri'W}4 o N o hOL,
VALUATION SOURCE GAS ELECTRIC
OF
9. UTILITIES
Enum. Dist.
Location (Area)
WATER
SEWER
5r, r1G
Ownership
Public 0 Private
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 INSPECTION
DATE OF APPLICATION
alb
SIGNATURE OF APPLICANT
C J PO/ gr g
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
EnvllHeal Ar'`'\f' a/(2 jos., FCba frivilT (s1A- 7271
)
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
a Io ,
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
$
PE MR IT NUMBER
r
stA -039'-2-
02* *14.00
*14,00
*14.008
A *0.00
839.02
0'81-21-81
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
8,3 1 1 9; 12. Zti, * 14 0 O.O J
a H -
PERMIT NO. TOTAL