1981, 09-18 Permit: 81A-9521 AdditionN NUMBER APPLICATION/PERMIT
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 A DRESS
_ 1�-.0p� LEGAL DESCRIPTION — SEE ATTACHED
1.
LOT B O H
2 OWN�ER����,1�
3. 0 'I�Lv
ADRE.SS
CONCONACTOR
4. ADDRESS
DESIGNER
5. ADDRESS
SUBDIVISION .('
TO
PcA+RCEL NUMBER/S +!_
Area of Decks
Finished Basement
Unfin. Basement
_4.(��'�
ftv—
'—
—
PHO
600
`x- Vj.
61
❑ MVE.
\(
�� - /� ���
Z ��']���
4d1 g — "�
Actual Set- Backs in Fe t
South
.�7r
/ `�
7, OF
North
East West
--��r,-� ��•I�-�'
PHONE
- Sa
Size of Parcel
l s
Z ne Classification
�.5LJ�q
/yij•frj,� y/
fJ /
p
T e onst.
V�
ccupancy
Sprinklered
❑Yes ❑No 11Req'd.
PHONE^'
Valu tion
Building ea in Sq. Ft.
-76
ZIP
M in Floor
-76
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
'—
—
_.
TYPENo.
❑ NEW ❑ALT.
❑ AD'N. ❑ RPL.
❑ MVE.
Baths
No. Stories
No. Rooms
No. of Dwelling!
7, OF
❑ OTHER
11BLD. ElPLMB.
1:1MECH. ❑ M. H.
1:1POOL
CERTIFICATE
Req'd.
Recd.
Not R 'd.
WORK
of EXEMPTION
I
DESCRIBE WORK I`
i�/I�t�j�VIc/�''
� �",� �,
Enum. Dist.
Location (Area)
FEES COLLECTED
s. V yc I (a
VALUATION I SOURCE GAS ELECTRIC WATER SEWER
OF Ownership USE CODE
9. UTILITIES Public ❑Private Single $
1 hereby certify that 1 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 �1 ////J►//� Plumbing
VDATE OF APPLICATION -4901L CD. /lJl SIQNATI IRF (1F APPI ICAnIT�Mprh- -
SPECIAL APPROVALS SPECIAL CONDITIO
Env. Health NAME DATE � VrG ��p ,
Plan Check
r>`v
17 I SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer
Utilities
PVns Ex &ist-
BujLdNg
Checkl
Te nic n
PERMIT IS NONTRANSFERABLE
Other (Specify)
TOTAL $ 10+
WHEN MACHINE VALIDAI
THIS BECOMES A PERMIT.
PERMIT R46NIBER
U* * 1 04,00
* 1 G, 0
* 1 04.001
A *(; )"2
94
09-1 6-81
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