1981, 02-24 Permit: 81A-1777 Residence, Renewal of 80-1614 'LAN NUMBER0.2/OCg_ � ' APPLICATION/PERMIT PERMIT
ERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
elNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 02 * * 6800
LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION 1 POD- •1413k3
PARCEL NUMBER/S
2. I 1.)ELLIZL.1 1�tl L., Vi 1 P�OD- , `3k 02,b2 * 6 8 0 0 6
OWNER PHONE
3. 56.7)-ITV t _A1IC Gi295t2_cn1 A * 0 0 0
ADDRESS ZIP,r Actual Set Backs in Feet
E • 0114 11'ltL Ii IELLI c. Cklz North 2-./bb !South !,L) East .3if 'West XCi 1 7 7 6
CONTRACTOR PHONE Size of Parcel Zone Classification 0 2-2 4-8 1
�.a1hl'116 12C)X PP)-'; 1:6r13. `_A:at`tf..I A/L) 6 4 7 4
4'
ADDRESS ZIP Type Const. Occupancy Sprinklered
•=11-11.116 CE t-` mi ..J Oyes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ,.- G
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. —
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE. ,_,„/ '1 I 6 1
7. OF OTHER
WORK
0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION Y/
DESCRIBE WORKEnum. Dist. Location (Area)
8. P rN,LIA_ - •_Jiink:NL>`<. rokrYkY ''.lOE"ivc:E. FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership 1 USE CODE
OF
9. UTILITIES Public ❑Private 'iW
Single $
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 Building e-.9•04"
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 – ..f4- Ri SIGNATURE OF APPLICANT 7/1 .icifit 194-0-d-4)-6,4— Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health -.EI\)eu.JIkL. C)r T.?o ' ILA 4 YL crc
SEPA d
Planning OU
Fire Marshall Mobile Home J
Li
Co. Engineer Other (Specify) ��
Utilities TOTAL $COQ:.oo
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
i
Building Technician PERMIT IS NONTRANSFERABLE 0'2'f 2 4'j-''8'.1- 17'7.'7'i •*6'8.0 111. g.. -
�,� t' PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL