1981, 01-06 Permit: 81A-0080 Residence [PLAN NUMBEK. APPLICATION/PERMIT PERMIT NUMBER-
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SPOKANE COUNTY — BUILDING CODES DEPARTMENT A — Qa
jNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
i:' `) * * 3G4.00
1. 3 7/ Se it207'('0/Zi.tr — Li-)LOT BLOCK SUBINI�SION PARCEL NUMBER/S 4: ,I L` r
2. et)
.y c, i �,�.>S/, ,S" 144 DA) 11170 r2T"iCstiS d f 19142c KJ. 7::t• * C 4.0 0
OWNER PHONE
3. at Sa cx #4 g s (.7_,r~ . /.,4,,cg .f-3.124':== 3.2.0/I - '0 6'S''— Poe? A * C. D C'
ADDRESS ZIPActual tyet Backs in Feet / ( / 7 n
u - ,5-....)-• , /?1t) S,' /2 v f Zr idc' C- Norte (South 1,1 East 4/0 (West TO 7
CONTRACTOR PHONE Size of Parcel / Zone Classification
4. -,54114 ‘-- /d d �d X/ A PP j, "ret,c l----444-.1
ADDRESS ZIP Type ortsf. Occupancy Sprinklered 6 47 9
ei�l At_ /t'-,5 Oyes t o ❑ Req'd.
DESIGNER PHONE luation SiBu
ilding Area in Sq. Ft.
�e.,7Z�'' �6 38
5'
ADDRESS ZIP Main Floor Upper Floors Garage AGrea Storage -
/
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. /3 d
TYPENo.Baths �N/o. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. El AD'N. ❑ RPL. ❑ MVE. .yam 7 -j4:ye' (�
7, OF ,�( ❑ OTHER Req'd. Recd. Not Req'd.
WORK XBLD. 0 PLMB. ❑ MECH. ❑ M.H. 0 POOL CERTIFICATE
of EXEMPTION x
DESCRIBE WORK Enum. Dist. Location (Area) T
(
8. . /.1...1::44. /54/-/,4 !}4Jj 67TH'' G 11IZ!'/6•� FEES COLLECTED
�/VALUATI��V SOURCE/ GAS ELECTRIC
A! WATER SEWER Ownership USE CODE
9. t' ' 9 e, UTILITIES ` ' i1,'?/ 11' i��� „lir 2r,, . Public ❑Private K Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included ,/,e
_
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this 3 G
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 regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS e'(1-‘ 14.
� Plumbing
DATE OF APPLICATION /z"� �– SIGNATURE OF APPLICANT ' `d� v( -�14.� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
En Heath �,(,��Idt
.(.cI/Beed A�S 1/ �4444e14'04t' 1 � " 1144-e / SEPA j
�
Planning Alr2-u '7 .-i., - w — .11
P' / - w
/'1" Mobile Home
Fire Marshall n 1d et�,t,i — e�f�Q.�C..-W= "`
.,cav i ct�p !-o- �w�'
Co. Engineer
7"'�` Other (Specify) '
/ O -36 -7'
Utilities i Q ep
TOTAL $3
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Bu9iling Tech •cian a 4'' PERMIT IS NONTRANSFERABLE 0'1'r�0''6 :{8r &0 z+' * 3 0 4:0 0 a H
'kr() 0(CL2L J PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL 1
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