1981, 11-19 Permit: 81B-1972 Pole BuildingPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,'vJASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. E, 1880g Liete
LEGAL DESCRIPTION - SEE ATTACHED
LOT
2. U
BLOCK
-1
SUBDIVISI7
C4r-T
PARCEL NUMBER/S
OO,�IN E R Q
3 11 -RI ivc.�
ADDRESS
/93a ' £, 1---/ 6E-47
CO TRACTOR -
4. e _- LS �I fL ,t4& OCs
DRESS
DESIGNER
5. ADDRESS
PHONE
ioog
ZIP
PHON
/.5S- 7
ZIP
'90 7
Actual Set Backs in Feet
North/ South
Size of arcel
East c.,) o IWest o? S
Zone Classification
1V W14
Type Const.
Occupancy
-
Sprinklered Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Val tion
a 023o
Building Area in Sq. Ft.
7.20
ZIP
Main Floor
Upper Floors
Garage Area
Storage
7,26
CHANGE OF USE FROM
6.
TO
Area of Decks
•
Finished
Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW 0 ALT.
LD.
0 PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not t qq'd.
DESCRIBE RK
[Le.
QQ
8. F�tOG
VALUATION
SOURCE
TILOITIES
GAS
1*0 S [3 a/12
ELECTRIC
WATER
Enum. Dist.
Location (Area)
G SEWER
Ownership �/
Public ❑ Private EJ
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
/e&---1/244244, C. C./�,
,
DATE OF APPLICATION 1/- 1 - (1 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
1k.11A,(
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
No -r
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
5 6.ti r r.,e
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 $ 3Fi.e30
PERM1T�N mpER R1
S13 ict12__
02*
A
1969,7
11-19,-81
'= 61i79,
* 31 00
* 3 00
* 3{.
0 0
*(' 30
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
9.-81
DATE ISSUED
197.22 *38.0Oa'-
PERMIT NO. TOTAL
--
COOK BROTHERS CONTRACTING
Route 2 Box 853 B
OTIS ORCHARDS, WA 99027
(509) 924-1557
JOB
h'A/pJ Ce.
SHEET NO. OF
CALCULATED BY DATE
CHECKED BY DATE
SCALE
E18309
FORM 204 Available from INC Townsend. Mass 01470