1981, 10-20 Permit: 81B-855 AdditionMBER APPLICATION/ PERMIT
S ® 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
5 4-4--rl LC<, 4 LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK BDIVI ION PARCEL NUMBER/S
ell .1;l!> ,- Iz k14A <-.,I ! P5 354¢
3. rww
ADDRESS
r'
PHONE
Z P Actual Set Backs in Feet
North South 10
CONTRAICIQEt
LV✓
PHONE
Size o ar`cel
ILTyy
Zone
lassifion
4' ADDRESS
ZIP
a �onst.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuati n//�_
Building Arqea in Sq. Ft.
lC�
i
5.
ADDRESS
ZIP
M
in Floor
Upper Floors
Garage Area
Storage
I
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
-J—'
Baths
No. Stories
No. Rooms
No. of Dwellings
TYPENo.
❑ NEW ❑ALT. AD'N. ❑ RPL. ❑ MVE.
7, OF, ❑ OTHER
/
WORK Ra BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
of EXEMPTION
I
jNcjP,-tI'd.
DESCRIBE WORK
�u 1 (> A —�
Enum. Dist.
Location (Area)
FEES COLLECTED
$ V�'T`I O
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership USE CODE
9.
OF
UTILITIES
I
Public 11Private
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
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
10- WMech.
DATE OF APPLICATION �� SIGNATURE OF APPLICANT
SPECIAL APPROVALS I SPECIAL CONDITIONS:
NAME DATE
rianning
Fire Marshall
Co. Engineer
Utilities
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
PP,�;./Ill h.IJMBFr2
* 5 V 0 0
*5 000
,SFE,
1 "-1 6--} 1
6479,
Mobile Home
Other (Specify)�j
TOTAL $ " o
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1: '-2.0" 8`1 8 5.5 z
*5a0Oa-,J- -
12�;15 1