1981, 04-06 Permit: 81A-3123 Remodel P:AN r4UIUIBER APPLICATION/PERMIT PERMIT NUMBER
/�/�/ SPOKANE COUNTY — BUILDING CODES DEPARTMENT -`'/
(/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
02 * * 50,00
JOB ADDRESS
'Y]�f/ .-'-7,4E, r il��� �� LEGAL DESCRIPTION - SEE ATTACHED1. * 5 0 0. 0 tii
LOY LOK SUBDIVISION . PARCEL NUMBER/5 �% r
'fi i ) <r. -/J * 5 0. 0 0
2. 1 1 //VI.L,P��� lit. ,ji411.!//4r.(--Q-1:4t-7%) A-4T ii r A7 rte.-7-
OWNER PHONE A * GOO S
3. t L• Ft,./...0-Y---/L '''.Z --P.--`1,_/,s A4/ %-A/f=/./., / �3%y
s
ADDRESS ZIP Actual Set Backs in Feet,,=� ��rl�1�� dL-,s/ J 2.2
.,/f,�Ci,!' 99;(,../i4-, North (south East west 0/1--0 6-8 1
C NT ACTOR PHONE Size of ParcelZone Classification
4. '�/� �, ( - --f4-6"1-� %'` �„�;t X Zs X/ r: r-
al)4-!,ii, -i / 4.,_, ,,,_ 2 6 4 7 9.
,,,9�``9DRES , G r fi, ZIP Type Const. Occupancy Sprinklered
�C)..(14/' 7,:!1 .)V._ !/,kc i.4—, g9.' I�f- J h•', + ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation „�' Builddii-ng Area in Sq. Ft.
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
f.2_iY/)
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE D NEW Al ALT. 0 AD'N. 0 RPL. ❑ MVE. fj f;�f „7
7, OF 0 OTHER
WORK 0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERT( ICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION X
DESCRIBE WORK Enum.Dist. Location (Area) '
741.•;4x10-4-1_41/_-///
t /J ,7 I FEES COLLECTED
8. {41.•;4 /_-/// -1 7C /” ./ r�/G 4r J y:e -
VALUATION SOURCE GAS / ECTRIC f WATER SEWER Ownership USE CODE
00 OF
.v '10 7 -- UTILITIES Public ❑Private [g] Single/ 9 $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included - 00 _
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this /Y
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 re• lating c nstruction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS c i Plumbing
DATE OF APPLICATION '? Tom`- / SIGNATURE OF APPLICANT d /, , :/' Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATEPlan Check
Env. Health ,�1/ 1 i i- -jlCA 1
{'V A� .Li.. -/ SEPA a.
Plahning a.
7
-- Mobile Home
Fire Marshall1 '* ✓� _ /�'"J�� ,f�l�/4!_�- ,�'�' -J
Co. Engineer "X � ��i-(,a`29) ek Other(Specify)
ki
Utilities / ,.../.1,,,
�1� L 7,1.-•� 171- -Cf g -P- ,r� �
TOTAL $ ,J ---
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Bui ding/'Tec nicia1 PERMIT IS NONTRANSFERABLE 0 41j'8 X6.-`'8'1 3123 z' *5 0.0.0 a i
,�r�/ / ,/f��.j4 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL