1981, 12-01 Permit: 81B-2318 Demo Residence PLAN NUMBER _ APPLICATION/PERMIT PERP i ��,`^9Ek
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 1-r3 '�
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
U
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS I I�� LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISIONPARCEL NUMBER/S cc,"15+:2)
__. 0 3,
C/J _ o. 00c
2. I 141 .c.-,7' 10K1 ill X'-1(1 iff. "(-3 '
OWNER
3. P r . 14 r.lci.ail ,?. -- 77c)1
ADDRESS ,y-t Actual Set Backs in Feet 2 3 7 2
s _ 117' __Z.," r '' ,2� North 'South East 'West 1 —0 1 ,'- 8
CONT R� ZIT 6- PHONE Size�ofParcel Zone Classification
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
dnr,
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage -
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE 0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE. /�
7. OF 'L'f OTHER CERTIFICATE Req'd. Rec'd. Noteq'd.
WORK BLD. ❑ PLMB. ❑ MECH. 0 M.H. ❑ POOL �ft
of EXEMPTION l'
DESCRIBE WORK Enum. Dist. ILocation (Area) ' FEES COLLECTED
VALUATIONSOURCE GAS ELECTRIC_1 WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private 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
I Y-
DATE OF APPLICATION / D f / 1 SIGNATURE OF APPLICANT I "< ^`';,-2 .- , / Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE '\ .,,, Plan Check
Env. Health
SEPA o
C
Planning _
C
Mobile Home L
Fire Marshall u
+ •20
Co. Engineer Other(Specify)
Utilities ''-i-0
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
B g Te icia PERMIT IS NONTRANSFERABLE 1 2,�- 1)17.8"1! 2,3 1.8 z * 20.0 0 2 I-. -
L,---- PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
J2,1 ,/, 1A /:111Xl I N4..)1 , 111
7
IF
(7),„
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