1981, 08-25 Permit: 81A-8513 ACs (PLAN NUMBER
i,
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 -COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
2.
3
LOT I BLOCK SUBDIVf51dN
ONNUR
i - mC u i eke&
ADD •.r5S
PARCEL NUMBER/S
CON,jRACTOR
5.
0/S
kP5E
o(,, -7/
dig 376)
DESIGNER
PHONE
Actual Set Backs in Feet
North South East West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy Sprinklered
Dyes 0No 0 Req'd.
Valuation )Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
6.
TYPE
7. OF
WORK
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
NEW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. yy mECH. 0 M.H. 0 POOL
0 OTHER
DESCRIBE WORK 47/e,
r /v .
VALUATION 5 URGE GAS - ELECTRIC WATER SEWER
OF tX/
9. UTILITIES
No. Baths '
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
1 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 gran ing of a permit does not presume
w regulati construction or the
performance of construction. EE REVERSE SIDE FOR REQUIRED INSPE.jTONS
to give authority to violate or cancel the provisions of any other state or lo
DATE OF APPLICATION
SIGNATURE OF APP
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Plans
Examiner
SEPA Checklls
o odo &: « '
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $'
Building
Plumbing C,,L/
Mech. / / Gc)
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
04* *1400
*1400 '6
*14006
A *000
851.2
08-25-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i I O
101'8 '215, ;8;`l 85'1''3.= *140O:0
-
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT NO: TOTAL