1981, 04-15 Permit: 81A-3574 Addition PLAN NUMBER J U E4t APPLICATION/PERMIT PERMIT N
if- FSA- '7' 1 /Si
S/ SPOKANE COUNTY — BUILDING CODES DEPARTMENT G
0/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS0 2 * * 2 5. 0 0
1, 1 .iiO WI I l> I., -( LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S o 39... - O'
2. 5�- / * 25006
3.
OWNER4� td< . 7 4-0O7O _ -,Ill> 1'1J/AN 0 * 0 0 0
ADGC JR/E`SS ',�Ih �f �� j �i� Actual Set Backs in Feet t,3 9 3 5
[!` 12.ei10 r "C%✓✓✓�✓✓1 7, 1 North Isout.3C) East 'West 13 0
CONTRACTOR PHONE Size of Parcel Zone Classification 0(( 1 0-8 1
a. �SLG o 6-a i ‘'� ,3-2,6-372-� 3 z'� x .'G v t' I�i�' n 6 r�7 9.
ADpREered
OSS• r50)( I B I 1 1 O. _ , p ZIP b TypeQnonst. O5.p�a5ncy Oyes ❑No Sprinkl❑ Req'd.
DESIGNER rUSM�1jA`[f� PHONE Valuatiq Building Area in Sq. Ft.
-° e'o
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage -
Q — ._
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. — _
,�(/ No. Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ EW CI ALT. CJ AD'N. CI RPL. ❑ MVE.
7. OF ❑ OTHER
WORK Bildi
BLD. ElPLMB. CIMECH. 0 M.H. CIPOOL CERTIFICATE Req'd. Rec'd. Not RetY9.
of EXEMPTION ��
DES RIBE WORK6. Enum.Dist. I Location (Area) '
8. 112 I� ;�/1�Q` FEES COLLECTED
VALLVATION SOURCE GAS ELECTRIC WATER SEWER Ownership �,,/ USE CODE
OF
t.
9. UTILITIES ✓ C/• Public ❑Private 6d'
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 .��
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�CSIDE FOR REQUIRED INSPECTIONS Plumbing
CDATE OF APPLICATION. /42C� om— SIGNATURE OF APPLICANT ,++C. ech.
SPECIAL APPROVALS SPECIAL CONDITIONS:/
NAME DATE g e� 1 Y/' . / 06-1,6-
16- - 0 * O? 12 y, Plan Check
Env th j( C,C/N VY(� 111 V fV Y�3/h/�I
0" SEPA s-
Planning ' lir fl -16 G0\-r' •v- lop _ ,5
Mobile Home -,
Fire Marshall ,_
Co. Engineer Other(Specify)
Utilities d0
TOTAL $ as._.-
Plans Examiner r
'TJltli Pas•-f WAV j6/57 WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
,I1rv, 1' Ifo, " 1 " 'i I. ►aO
B •'ng -
aan PERMIT IS NONTRANSFERABLE 0 4r } 5,7 1 35 Z4 z *2'5.0.0 1.iJ-
/!
i PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
i
130' 171 , 'j k19t1
/'c eel -42 P'L'C
7161 -14
t
N
$0104 eAtel
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