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1981, 10-26 Permit: 81B-1078 ACN 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 LEGAL DESCRIPTION — SEE ATTACHED LOT BLO K S BD VISIO PARCEL NUMBER/S 2. j� OWNER PHONE &0E ADDRESS � ZIP Actual Set Backs in Feet ze Z -North South East West CONTRACTOR PHONE Size of Parcel Zone Classification 4. ADDRESS `/��CJ.Z Type Const. Occupancy ❑Yes ❑No Sprinkl❑ Req'd. A21Z Lj DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement s. TYPE❑ �No. Baths No. Stories No. Rooms No. of Dwellings NEW ❑ALT. AD'N. ❑ RPL. ❑ MVE. 7 OF WORK ❑ BLD. ❑ PLMB. �MECH. ❑ M.H. El POOL OTHER CERTIFICATE Req'd. I Rec'd. Not Req'd. of EXEMPTION DESCRIBE WORK Enum. Dist. Location (Area) 8 t- � �� [�� 0�� FEES COLLECTED VALUATION I SOURCE GAS ELECTRIC I WATER SEWER Ownership USE CODE OF 9. UTILITIES Public ❑Private 1:1 Single $ 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 Building 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 , Plumbing DATE OF APPLICATION & SIGNATt1RE OF APPI ICAN 1�Mech. SPECIAL APPROVALS NAME DATE nv. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SPECIAL CONDITIONS: Plan Check SEPA Mobile Home Other (Specify) % TOTAL $ / 4/N // PERMIT NUMBER 1©-78 4* 16,00 * 1 u0 *1[.00 A 1 07: r7 10 2�-81 1 6479, WHEN MACHINE VALIDATED IN THIS SPACE, — Checklist THIS BECOMES A PERMIT. i ��echnician PERMIT IS NONTRANSFERABLE '1 i{j�.�i.`•1.�'t-8 t' l %$ z aa..,IJ