Loading...
1981, 05-08 Permit: 81A-4500 ResidencePLAN NUMBER �;I - / ;/ g/ 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 1. JOB a DDRESS 5 k;hOro 2. LOT 3 BLOCK SUBDIVISIONAOC LEGAL DESCRIPTION — SEE ATTACHED OWN R 3. kJ k 711.{ C, ADDRESS `fieP�N' CONTRA C5 4. ADDRESS PHONE 28 '3(9t2 I Pg PARCEL NUMBER/S 4i 03 PHONE Actual Set Backs in Feet North 'South 22 East Size of Parcel (West 1� Zone Classification 4.1Q61, vitivt ZI P TyyelConst. 5. DESIGNER PHONE Occup ncY /M.1 Valuation 56E', Sprinklered ❑Yes No ❑ Req'd. Building Area in Sq. Ft. ADDRESS ZI P CHANGE OF USE FROM 6. TO Main Floor jQCo Area of Decks Upper Floors Garage Area 2 P, Storage Finished Basement U fin. Basement Ba TYPE 7. OF WORK 'NEW ❑ ALT. "BLD. ❑ PLMB. ❑ AD'N. ❑ MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑POOL 0 OTHER No. Baths No. Stories No. //F3ooms `.O No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Recd. Not7'd. 8. DESCFAE WORK Enum. Dist. I Location (Area) VALUATION 9. SOURCE OF UTILITIES GAS ELECTRIC WATER SEWER oT16 Ownership Public ❑ Private V 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 law regulating construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS DATE OF APPLICATION ,5 1 SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE Env. Health 1•1/I'' 4 /1,-7 [51 Planning Fire Marshall Co. Engineer 6 -VA Utilities Plan< Examiner / 'ft raj'LG,Av K z fr vl SEPA Check'ist SPECIAL CONDITIONS: mo( cAt c9 _ -re)f- IJi2 i 1J - 11-- AeS4 . y Rt.: -.C -1;E c I5/2„i /E3i PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building 1'77 Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ If, PERMIT NUMBER r� _"¢500 02* *31300 *31300 17, *313.006 A *000 0 449.72 05-08-81 6479 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 05; 0I&, 81 450.02- *+31300 DATE ISSUED - a ►J - PERMIT N0. TOTAL !/I' T" RS' 9a0 S , C� GAG. pk:ACE Lie, ✓t. K /p 5744 ..AetAQ' 9 (,t Lo T.3 oz_oCK3 1