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1981, 09-21 Permit: 81A-9594 ReroofPLAN 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 ADDRESS e . e6B0 ci lAD OCD\` C. -A W.).ti � r2 LOT BLOCK SUBDIVISION 2. OWNER PHONE 3 r . yv� . C� c�ti e. No Nl 5 65- -' --c1A- ZIP 4. ADDRESS . t3600 CONTRACTOR JAw LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S Gp Cl,ucc IZ>=t'CAZ 3L.4it eat, PrivCJ r WTh '2.415 LVC- IC.. Lllt 'Ft. 23631- 113Ci Actual Set Backs in _FeI cm) 'South SouthllCC ll East West ADDRESS DESIGNER PHONE ZIP ADDRESS 6. CHANGE OF USE FROM TYPE 7. OF WORK ❑ NEW ❑ BLD. ❑ ALT. ❑ PLMB. PHONE ZIP TO ❑ AD'N. ❑ MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL Fr/OTHER Size of Parcel E.A.I (UL.% Zone Classification A(_1 .bL.4.IJ�A ��ry Type Const. .1. Occupancy 'R-3 Sprinklered Yes ❑No ❑ Req'd. Valuation Ill Building Area in Sq. Ft. Main Floor Upper Floors Garage Area Storage Area of Decks Finished Basement Un in. Basemen No. Baths No. Stories No. Rooms No. of Dwellings DESCRIBE WORK 8. 126 — tw kZaS S1VCx. CERTIFICATE of EXEMPTION Enum. Dist. I Location (Area) VALUATION SOURCE ELECTRIC WATER OF 941 UTILITIES 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 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 GAS SEWER Ownership Public ❑ Private Req'd. USE CODE DATE OF APPLICATION SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Buildi Technicia SIGNATURE OF APPLIT' SPECIAL CONDITIONS: Rec'd. Notlteq'd. FEES COLLECTED Single $ Building 1q,00 Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ l9.GU PERMIT NUMBER g 1 A' -C Sci4- 02* * 1 9.00 • * 19.00 17) 959,32 09-21-81 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. Og;_ 1.-g1 959.42 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL * 19.00aJ_ PERMIT IS NONTRANSFERABLE