1981, 08-10 Permit: 81A-7913 Siding, Soffit, Fascia, WindowsP
PLAN NUMBER b ,1
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
JOB ADDRESS
Inn
LOT .D�9 7'�Iin F.J ISIO
2.
LEGAL DESCRIPTION - SEE ATTACHED
3.
5.
OWNER
I a u)re,in('n7 (. 011-x(7.
PHONE
61,2 to-sy&a
PARCEL NUMBER/S
/766cR oia3
ADDRESS
& ' 19Qa,z h'1 I's•sInn
CONTRACTOR
ATCV(y biro' -t's Omf TC.
S
N • 3t o b Ar fc on ru kocrct, .
DESIGNER
PHONE
9'a8- 4&2
Actual Set Backs in Feet
North . 'South
Size of Parcel
East
'West
Zone Classification
ZIP
99ao6
Type Const.
Occupancy
Sprinklered
Oyes 0No 0 Req'd.
PHONE
Valuation
VoZ3"
Building Area.In Sq. Ft.
ADDRESS
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
O NEW
O BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
O M.H.
O MVE.
O POOL
EFS
Ref) Lucvt
.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK ('
S. VALUATION%PJJ 45G{.f.
OURCE
9.'1073.00 UTILLIITIES
5
7aSOCIOL, (A.1autd2
ELECTRIC
WATER
Enum. Dist.
Location (Area)
SEWER
Ownership
Public ❑ Private 0
USE CODE
I hereby certify that 1 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 INSPECT NS
DATE OF APPLICATION
SIGNATURE OF APPLICANT
fL
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
EPA Checklist
B ng T nic
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERAB
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $80,00
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other, (Specify)
TOTAL $/]O,W
PERMIT NUMBER
iA- -79122
02* *8Q.00
*80.00 16
*8Q008
A *Q00 8
791.2
08-10-81
A' 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
l,l j:!O 1 it i�
O'81.I�,UI-;81; .;
7 91:32
DATE±ISSUED PERMIT NO.
80,DOa.e. -
TOTAL
Y
0
0
U
J