1981, 06-01 Permit: 81A-5336 Siding, Soffit, Fascia, GutterPLAN 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
JOB S
1. LOTAD BLOCKSSUBDIVISIGN1
2. . ^i:,
'LEGAL DESCRIPTION — SEE ATTACHED
3
4.
5.
OWNER
£Atn n }d. SGlu.tbaCil
PHONE
gay—tIooq
PARCEL NUMBER/S
`r' y1-1-- opt
ADDRESS
. S 05: Mr) (a.
CONTRACTOR
l
M 1P-V6-t;j' E10 1.e(-3 CC31'fracErs
ADDRESS
3l0(.0 Largon Ecool
DESIGNER
ZIP
PHONE
4a8 4-6go
P
atgo&_2
PHONE
ADDRESS
ZIP
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Yes ❑No 0 Req'd.
Valuation Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
0.7W /ALT. 0 AD N. ❑ RPL. ❑ MVE.
D. ❑ PLMB. 0 MECH. 0 M.H. 0 POOL
DESCRIBE WORK
8.
VALUATION SOURCE
9.3X00 1 &‘1%) UTILITIES
OF
GA
Area of Decks
Finished Basement
Unf In. Basement
ELECTRIC I R
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Ownership
Public 0 Private 0
USE CODE
Req'd.
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
DATE OF APPLICATION - SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA CheCklIs
PERMIT IS NONTRANSFERAB
PERMIT EXPIRES ONE YEAR FROM DATE 0 SSUANCE
Rec'd.
Not Rec'd.
FEES COLLECTED
Single $
Building
Plumbing '
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL$ I t,OD
PERMIT NUMBER
SIA - 5335
02*c *44.00
*4400 tn
*44.006
A *000 8
53358
• 0'6-01-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOTES A PERMIT.
l' " i 1
t
5 ) 61Z, 4 argliA
DATE ISSUED.. . PERMIT NO.
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