1981, 11-06 Permit: 81B-1584 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
6
SPOKANE COUNTY - BUILDING CODES DEPARTMENT /�'' //�``JJ 111114 11 �
e// NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1 1 04-1 ``I-- LEGAL DESCRIPTION — SEE ATTACHED 0 4 * * 1 7. 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
* 1 7 0 0
2. * 17006
3. OwpE,R �. G/ D 1-_,..771--2,052.-- A * a t; o Ei
ADDESS ZIP Actual Set Backs in Feet
158
��� � North (South East (West
CT:NJTR I OR I I PHONE Size of Parcel Zone Classification 1 1 _ 0 6_ 8 1
4.
ADDRESS ZIP Type Const. Occupancy Sprinklered 6 4 7 9,
❑Yes ❑No E Req'd.
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
6.
TYPE �// No. Baths No. Stories No. Rooms No. of Dwellings
Ll NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF / ❑ OTHER
WORK 0 BLD. 0 PLMB. MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area) '
8. I", CJP.i e�„/,
ICS -V b a KI�� FEES COLLECTED
I
VALUATION SOURCE GAS ELECTRIC WATER SEWERUSE CODE
Ownership
OF Public 0 Private ❑
9, UTILITIESSingle $
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 Building
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 // 4lp/ SIGNATURE OF APPLICA — - C4-4,61...{6''
/�a/ Mech. 17
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA a
Planning U
— w
Fire Marshall Mobile Home . a
Co. Engineer Other(Specify)
Utilities
TOTAL $ I�J
`
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
`-134 g`ec n'ibian — PERMIT IS NONTRANSFERABLE 1.1}'G-6-'8 1 1,5 8,4 Z * 1 7 0 0.2 i
�..�' PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL