1981, 10-26 Permit: 81B-1094 SidingPLAN NUMBER APPLICATION/PERMIT
PERMIT NUMBER
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
1. 111 0a �G LEGAL DESCRIPTION — SEE ATTACHED
a 2* * J (0, a s
*v as V)
LOT BLOCK SPARC€L NUMBER/S
OW R i� �"'' IV�L Y4' VV(��- �-�- IiV y,�- �s
c?
�P+HONEi Ii i i ,cam
�'
A* 00
3.
ADDRESS r ZIP Actual Set Backs in Feet
1 0 Q 3
/
North South East west
CONTRACTOR PHONE Size of Parcel Zone Classification
10-26-81
4.
AOD�F�yESS ZIP Type Const. Occupancy Sprinklered
�
IV ❑Yes ❑No ❑ 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.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE❑ NEW ❑ ALT. ❑ AWN. ❑ RPL. MVE.
❑
7, OFOTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK 11 BLD. ❑ PLMB. ElMECH, ElM.H. ❑POOL ,
of EXEMPTION
DESCRIBE WORK Enum, Dist. Location (Area)
8. FEES COLLECTED
d
VALUATION SOURCE GA ELECTRIC WATER SEWER Ownership USE CODE
UTILOITIES Public ElPrivate ❑ Single $ rX) v ��
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
1
DATE OF APPLICATION ` SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS
NAME DATE
,v. Health
Planning
Fire Marshall
Co. Engineer l
Utilities
Plans Examiner
SPECIAL CONDITIONS:
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 3 Y
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Tech S PERMIT IS NONTRANSFERABI I Q'-•� 6 — 8
.-�Z1