1981, 04-01 Permit: 81A-2947 ResidencePLAN NUMBER •
43/ 7 -4////v
C-
APPLICATION/PERMIT
SPOKANE COUNTY — BUIL.DINC.CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1.
LOT
2.
OWNER
.17
3
4.
- ✓f - 3
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK
SUBDIVISION
PARCEL NUMBER/S 3,zI _,=_ I�l lv I
.• Ink'6?1-tii ."1 �o
PHON
r,5
177�'
ADDRESS
36 3 o 0C--)11 /6\\/
CONTRACTOR
ZIP
Actual Set Backs in Feet
North —" 'South
East West
PH NE
ADDRESS
ZIP
Size of Parcel
103
Type fonst.
NI
DESIGNER
5' ADDRESS
PHONE
Valuation
ZIP
Zone Classification
<11 ().9
Occupancy
q3 it
�!0
1.1
Main Floor Upper Floors
IrAr a o l '
Deck
�G-�v'�
No. Stories
.27
CHANGE OF USE FROM
6.
TO
TYPE
7. OF
WORK
EI /NEW ❑ ALT.
Ind BLD. ❑ PLMB.
❑ AD'N. ❑ RPL. ❑ MVE.
❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
2.0 -2
Garage Area
Storage
Finished
Base
ent
Unfin. Basement
No. B the
Y3
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
NotikR/9.er d.
DESCRIBE WORK
8. r>I'i61 0E1\Ic ISI/ CV\ tc'L1C>.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
Enum. Dist.
ILocation (Area)
ELECTRIC
WATER
SEWER
Ownership ,.�
Public El Private Ll
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 rlating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION '
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env.ealth
Planning
Fire Marshall
Co. Engineer
6K eq
Utilities
J ".
Plans Examiner
✓7OM Po 51aWh1T4fid
SEPA Checklist
Kfi
SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
L. l(.,4tcPscE.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specifyl
TOTAL $
PERMIT NUMBEI
9'7
02* *364,00
*364.00
*364,00M
A *00,0
281.38
03-27-81
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 ,4,4
DATE ISSUED PERMIT NO. TOTAL
2.9475 *364,00a172
4
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