1981, 12-17 Permit: 81B-2855 MH PLAN NUMBER .
APPLICATION/PERMIT PERM'T NUMBER
SPOKANE COUNTY 7.- BUILDING CODES DEPARTMENT ea% 9.25
' s
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. NI. VI:X. Wlt�2ac.A2 LEGAL DESCRIPTION — SEE ATTACHED 7 * * 5 G.0 G
LOT BLOCK SUBDIVISION PARCEL NUMBER/S'? - V -C A
2. IFI.1tc,, 0 c S.2rOj' C5� TPJ .-T>c .'Se-i 4.0,G.1
J n
OWNER PHONE * 5 G O G 6
3. Pz c -rcoN) cZa.4-143tS 1--c:::) --7e
ADDRESS ' '/ ZIP Actual Set Backs in Feet A * 0 0 0 8 '
1.). a,,,-)..D_ Kv�lt,.i??,,,,f;Z CACI.:1CC North SouthEast 'West G 7 G 6 .r_
CONTRACTOR PHONE Size of Parcel Zone Classification
4. �Irvlav✓ 1107 X 3 3c, A6,2%L.,AA-,-c..A 2,A,�. 1 2- 1 6- u 1
ADDRESS ZIP Type Const. Occupancy Sprinklered
r---1"7Y11 (J 12.•.'' ❑Yes ❑No ❑ Req'd. n `"4 7 9
DESIGNER PHONE Vakiiation Building Area in Sq. Ft.
coo 10
5. ADDRESS ZIP Mai7'
Floor Upper Floors Garage Area Storage _
170 —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. — -- ---
TYPE �/ No. Baths No. Stories No. Rooms No. of Dwellings
00 NEW ❑ ALT. 0 AD'N. 0 RPL. 0 MVE. 1 2 ea.,
7. OF �I ❑ OTHER
WORK ❑ BLD. 0 PLMB. 0 MECH. LJ M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Notyq'd.
of EXEMPTION
DESCRIBE WORK Enum.Dist. I Location (Area) t
8."tn.IC LE L'- 0E (f}3i�E, 14-cME (14-X'5 FEES COLLECTED
I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership /JSE CODE
OF C �
� Public ❑Private
U•I/
9. aj UTI LITIESTtC- vaSingle $
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 l - �/� - SIGNATURE OF APPLICAN r4 i.-',71/ ,„...,e _a.......„ ).. ,
Azel. , Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: „,„, 4`,
NAME DATE nob, 10 mr, BIZ ---Jet ,y\ i'lt.i'/r Plan Check
Env. th �CC-I4-rtaE CiAm-40-81
/*Z-//lp SEPA Q
_
•�; ng �,�O
i2 /bf( Ct — c/ 4 i U{ f // / / Mobile Home 50.06 ue+
ire Marshall
i
Co. Engineer Other (Specify)_
t Stc tvcyt7P- bac
Utilities
TOTAL $ -OU
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
B -ding T chniciiann PERMIT IS NONTRANSFERABLE12,'7 i'7." 718 1,
2'85.5Z. *,5 a 0 Q F.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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