1981, 09-14 Permit: 81A-9293 Remodel IPLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER d
I SPOKANE COUNTY — BUILDING CODES DEPARTMENT 8111- - (0'613
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 ..
(1S APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED 0 2 * * 3 2 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S + * 3 2 0 0 m
2. 4- 2.-- �`iri"oR-ri_Jk I`11' I` -a % -�.�~j tf- I�O� 9 2 9.2
OWNER I PHONE
3. M.115,-1' et- ri614I 1\i t., ,22 _4743 0 9— 1 4—8 1
ADpRESS I 1 IP Actual Set Back Feet
12-x»1 I^i� (=AW NI RJ - ico I `x, ;1wc1 I 4 7 9.
North South East West
CONT A TOR PHONE Size of Parcel Zone CI ssification
4. ADDRESS ZIP Typggonst. Occupancy Sprinklered
V'`VI -- ❑Yes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft. •s.
5. L9
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. 1(0
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
0 NEW ALT. 0 AD'N. 0 RPL. ❑ MVE. t
7, OFI=1OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not 5(eq'd.
of EXEMPTION ,V/
DE CRI8E WORK Enum. Dist. Location (Area) r
8. I►I,�f 01L g64-19 ( >r) . FEES COLLECTED
VALUATION SOURCE GAS EL CTRIC WATER SEWER
9. 2-COC OF �G/ Public Private USE CODE
v � UTILITIES Single $
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 .jam.
Building ��
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 Plumbing
T-) . i
DATE OF APPLICATION ___?-'` t"-$ I SIGNATURE OF APPLICANMech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
AME DATE 11I A rz 1r n, yam. A ip, kT i�. Plan Check 13211..
Eny.He f�r�` (/I� Homo (y
h►^ ®`� SEPA
Planni g Y 9� . 1 _ O
A q.03.02o 0 7)
Mobile Home w
Fire Marshall J
Co. Engineer Other(Specify)
Utilities
TOTAL $ 5a. .00
Plans Examiner
Tarr) eor"I /el(l4i'- ?//I17/ WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
a ian PERMIT IS NONTRANSFERABLE V/91-41-. `l 9"2 9 3 °z * 32.002g
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL