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1981, 12-11 Permit: 81B-2692 ResidencePLAN NUMBER . .. eh, 5413 APPLICATION/PERMIT SPOKANE COUNTY—aBUIibDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3•COPIES JOB ADDRESS 1. E• 1t30G.. N.11 ¢csa LOT BLACK SUBDIVISION 2. A3t� — 7S — 04-1 OWNER 3 4Aa-f ADDRESS S 'T2G2 rcc' . LEGAL DESCRIPTION — SEE ATTACHED PHONE PARCEL NUMBER/S 61112- q0 -74 - ZIP aa. Actual Set Backs In Feet II � North 'South (East Sea (West CONTRACTOR 4. S,sn c ADDRESS Sart PHONE Size of Parcel tQmss. Zone Classification $4 3 iC.112-1CuL.TU2WL- ZIP DESIGNER 5' ADDRESS PHONE ZIP Type Const. Occupancy M Sprinklered OYes 0No ❑ Req'd: I V ation ' Building ggArrea in Sq. Ft. F501 1 lyea Upper Floors Garage Area Main Floor tilde Cp4G 484 Storage CHANGE OF USE FROM 6. TO Area of Decks ixs Finished Basement Unfin. Basement Cti4 7. TYPE OF WORK NEW BLD. O ALT. ❑ PLMB. O AD N. 0 RPL. 0 MVE. O MECH. 0 M.H. 0 POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK ' .,L" B. SINGLE. CPatL'1 ^'-<ESipc,vc.�. a(�e/atIE 14Trr c.0 [r��V�AALUATION . W1 COD 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 construct}or the performance of constructiy SEE REVERSE SIDE FOR REQUIRED INSPECTION / SOURCE OF UTILITIES GAS 1 ELECTRIC WATER Enum. Dist. Location (Area) SEWER GPS C - Ownership si USE CODE Public 0 Private DATE OF APPLICATION SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE :Faith a ning Fire Marshall Co. Engineer IIN�Si 12-14 Plan 6.lteyn er 1 1- st frt SEPA Ohecklist $eftym chnlcian SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building 4 2:.i.zi Plumbing - Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $Cio PERMIT NUMBER g\a 02* *28600 * 28600 y * 286006 A *000 260'02 12-09-81 2 64.79.. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. '17 tint' ,1� if lI DATE ISSUED .1 2:6`9.2'g *2i86.00(TO PERMIT NO. TOTAL /-r 1177 rt 4, 0 go ' ,,1 1000 c, dor) geotY0 o e- 0 -1 _J— \c) a , 07) 5' 1 0 • -X• • • • , - ..-,:i.4titi,4:-C.-.,:!,;j0:1,7g;:"‘14,3 • pn , 'tkr