1981, 03-26 Permit: 81A-2803 Residence IPLAN NUMBER S fa��Y/ APPLICATION/PERMIT �g� v;M
ri611/./6' 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
1. ;��C., ki�4 C�14,`t t�ihL, LEGAL DESCRIPTION — SEE ATTACHED 0 2 * * 4 3 O.0 0
J�/ * L'. 3 0 0 u3
LOT BL CK SU DI IN PARCEL NUMBER/s,
2.JO \.' May P�7�.,-r-r' .�'5.473/63 /c% .Z z.:07-47, .c3,-. . .S 0(iii,cm -,.,r.47,T.4lt-� /4 .Z-
OWNER PHONE * 4 �' 0
3. ,,5 • c.; z�-- 7ze: 2S3-51-/ 3/cC A * u 0 0
ADDRESS y C�- � ZIP Actual Set Backs in Feet
iyc'• .ec%X Jf/6/ /�i/�/4/ -� it% �fr2/ North.3O 'South 30 East 20 IWest EC 2 8 0, 2"-
CONTRACTOR PHONE Size of Parcel Zone Classification
�,9 I77 Gr 1 )( / 7X , 7 Xp/G, Kb63 5%xiez.z" Imre y 0 3-2 6-8 1
4 / 6479.
AD RESS ZIP 17--7z4
,X,,,, O x /3m Oyes �No Sprinklered❑ Req'd. r
DESIGNER PHONE Valtion Building Area in Sq. Ft.
5. DA/72 --- i8/S Z'19
ADDRESS ZIP Main Floor Upper Floors Garage rea Storage _
20062372 — ‘2
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. ta �z „A/r_w,i,l-r�Er 4:/' i< .2_ '- )L70 110Z
No. Baths No.Stories No`. Rooms No. of Dwellings
TYPE
KNEW 0 ALT. 0 AD'N. ❑ RPL. ❑ MVE. 0 OTHER 4-
7, OF ' -
WORK °1G t1`' BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL. CERTIFICATE Req'd. Rec'd. Not Req'd.
/J _ pddd` �/ of EXEMPTION X,
DESCRIBE WORK �Y_��s(/�,I .-,0J._-4�,.f./f Enum.Dist. ILocation (Area) ' FEES COLLECTED
(VAALUAfTIIO�N SOURCE GAS ELECTRIC WATERrSEWER Ownership I USE CODE
-fi�'' 7J.P UTIL TIES (,�C/c�- VG"/�i°tr L'�/C/q Public ❑Private l� Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included e0 _
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building Q
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 re lating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
I
DATE OF APPLICATION-21.-76 S`+ / SIGNATURE OF APPLICANT �'^`� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATEo.KPlan Check
c�A-'C� ,�4� 111
Env. e
V // SEPA >--
0_
PI nning OU
Mobile Home ".4
Fire Marshall J
/ LI-
Co. gi er / //( Other(Specify)
Utilities /` '/ n
TOTAL $ 4-.3.e.-----
ans Examiner
Tor' pa 51-4to/1rfT 3/ZL40 WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
•
Bu�dingTe,hni9jan *7 PERMIT IS NONTRANSFERABLE Q�131 2i6t.�8,�1f 28a3z' *43'aQ.'QaF -
4(2 '„(? "!_✓i L PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE ' DATE ISSUED PERMIT NO. TOTAL '