1981, 07-06 Permit: 81A-6666 ResidencePLAN NUMBEI' t.: • g,
6/A 335
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
LOT
BLO K
OWNER
3.
oc JrJ-
SpeD,V�
] yr, �7 '
�V V✓ 1'� G��' P5W'
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S .52..Y 4 I
ADDRESS
CONTRACTOf�.�
4. ADDRESS
ZIP
9P922 -E
Actual Set Backs in Feet
North (South I' ° Eas
ZIP
(West 2?
SiI5 Parcel 8 2- ZoiClassification
Typfe—onst c•�J{ItVI I�1�rAkil.
Occupancy
Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER
J. ADDRESS
PHONE
Valuation
ZI P
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Main Flo b� K
rUp e Floors Garage Area
I4�0 �� 71
Area of Decks Finished Basemen
Building is in $q. Ft.
Storage
Unfin. Basement
,1 -a -/NEW ❑ ALT- ❑ AD'N. ❑ RPL. ❑ MVE.
l BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
11 .(looms No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
of R.dq'd.
DESCRIBE WORK
8. k t b G�
Enum. Dist. I Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
G S EL CTRIC WATAR
rllvl
SEWER
�(IG
Ownership
Public ❑ Private
USE CODE
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 la jegulatinconstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
v Heal h
P annin
9
Fire Marshall
Co ner
:TL? '1/ 6/ /
Plans E miner
7/0/ C'
SEP Checklist
SIGNATURE OF APPLICAN
SPECIAL CONDITIO
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $ '3�
Building ✓7&
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUIkC3ER
0:2* *37600
*37600
*37600M
A *000 S
657.3
07-01-8.1
6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
tA14 g'1` 66'6.62 *376002 -
DATE ISSUED PERMIT NO. TOTAL
3O
t�ca1
Lo -t 5 B lock 3
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5L
20 ALD Cc»tI
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