1981, 06-02 Permit: 81A-5386 Inspect Fee PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
51A – #r•38b'
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 * 8, Q U
1. I;$I.. – 6 V11el4 LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * ` ~
2. * " 0
OWNS ✓ �' PHONE
3. Pl_Ci r !' r o C c
ADDRESS ¢/�pf�z Actual Set Backs in Feet
-.. 1&68) V001/4 /p✓ North (SouthEast (West
CONT TOR PHONE Size of Parcel Zone Classification ' r—c, 5—;- 1
4' ADDRESS��rvrv'' ZIP Type Const. Occupancy Sprinklered 67 r
❑Yes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
s
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.
7. OF / ❑ OTHER
WORK
0 BLD. 0 PLMB. �l MECH. 0 M.H. El POOL. CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK 1f'(it\i&r Enum.Dist. I Location (Area)
8. /1y I, 6 , ( ov �.�{ n) FEES COLLECTED
VALUATION
'SII �" ' I
SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9.a UTILITIES Public ❑Private 0 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
tvpe 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 INSPECTIIOOS� Plumbing
r JF APPLICATION�7k�d/ SIGNATURE OF APPLI NTC /` ./��/P� Mech.
v,
iPECIAL APPROVALS SPECIAL CONDITIONS://��
NAME DATE ep ..•• c/b/ / 44Plan Check
Env. Health / O L'
J SEPA n)
Planning
Fire Marshall fr4744j, El'440( ' u 4-Z4. – cU Mobile Home w
p /i a 14
Co. Engineer Z. �'t''�!� o �'1�u1� /‘ �� Other (Specify)
l�
Utilities
TOTAL $ A
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
•
Buil e �... PERMIT IS NONTRANSFERABLE 0 b%',.* 8''`' t .a ii 5 3 &6 c sir&0 0.2 H -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL