1981, 09-08 Permit: 81A-8976 Residence PLAN NUMBER APPLICATION/PERMIT PERNW,'IT NUMER
�/.9. 4416 SPOKANE COUNTY - BUILDING CODES DEPARTMENT ' & `h B9 7a'
(-,/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. a., '3d 0 III C�iid to LEGAL DESCRIPTION - SEE ATTACHED = '
O BLOC sypp qN PARCEL NUMBER/S ..z75,J 2
7 1, v j��t G�-a
2. * lc-,L o n
OWNER 14 , � d5 7 * i' i '
�II �1Y ,"- is �.
3 ADD S r ZIP Actual Set Backs in Feet
IS/ R �l /�A t c 7 �'
N � ���� !/ /�"�� North IQ (South East�y (West
CONTRACTORCONTRACTOR of Yf.' II/�y� li _ C : —Cs 1
4' ADDRESS ZIP Type Gonst. Occupancy Sprinklered i `,
`V/N 3 ❑Yes 0N ❑ Req'd.
DESIGNER PHONE Valuation � q, Building Area in Sq. Ft.
5. �7 �o l.�' gel'
ADDRESS ZIP Mainn/Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Areao Decks Finished Basement Unfin. Basement
6. —
TYPE // No.Baths No, Tories No. Rooms No. of Dwellings
LTJ NEW 1=1ALT. ❑ AD'N. 0 RPL. 0 MVE. �-�(}�
7. OF ❑ OTHER
WORK BLD. ❑ PLMB. 0 MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not q'd.
of EXEMPTION r/
DESCRIBE WORK Enum.Dist. I Location (Area)
8. FEES COLLECTED
�i WI•,C .
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership v7USE CODE
OF
9. UTILITIES ��f(jy7 Public ❑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 -
DATE OF APPLICATION 2s I SIGNATURE OF APPLICANT I.Alledi 4 ,1_440,j! Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE14c-., (aiF l 'KC- z78SV 53A)2-)
/
Plan Check
Env. hlealth
Nicyr
Planning I FC.! (.. I ��/, I 1 SEPA )_ cp
J ILJ J Mobile Home ".
Fire Marshall
C.Z.
Co. Engineer 77 Other(Specify)
Utilities 7 TOTAL $_ _
.ns Exa if
.01S WHEN MACHINE VALIDATED IN THIS SPACE,
SE"A hec "st THIS BECOMES A PERMIT.
, Build' - Tolik‘n PERMIT IS NONTRANSFERABLE :0.91yi�& wi8 1'' 8 9 7:6 z' *18400 a
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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