1981, 08-20 Permit: 81A-8375 MH 1PLr AN NUMBER APPLICATION/PERMIT PERMIT NUMBER
_,� SPOKANE COUNTY — BUILDING CODES DEPARTMENT
�// NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
j7 * * 50. 00
JOB ADD1. - LEGAL DESCRIPTION - SEE ATTACHED * n 0
l
LOT BLO SUBDIVISION PARCEL NUMBER/S r-'
2. --2----- I S i ,2A 1r, `C, A09-1. G8- 2C— 1
OWNER PHONE
3. C f1 � 10(10E a` -`114-7 = 6. 479.
ADDRESS' I ZIP
Actual Set Backs in Feet
- 72-c:2 ,2-416) "1--, y -, North 7--(-77--(-7 'South East 2 +
'West 1'/
CONTR CT R PHONE Size o_f Parcel . Classifica ion
17717 ISL_=', NI . N
4' , �
ADDRESS ZIP Type, nst. Occupancy Sprinklered
VV 2.7 Elves ❑No Cl Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage -
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
No.Baths No. Stories No. Rooms No. of Dwellings
TYPE ESir
NEW 0 ALT. ❑ AD'N. 0 RPL. ❑ MVE. in
7. OF �/ CI CERTIFICATE Req'd. Rec'd. Not t'd.
WORK Cl BLD. El PLMB. 0 MECH. LJ M.H. ❑ POOL 1/
of EXEMPTION
DES RIBE WORK Enum. Dist. I Location (Area) r FEES COLLECTED
8. 0Ili 1-h\11 --.. (It : `) I
VAL ATION SOURCE GAS ELECTRIC WATER SEWER Ownership y USE CODE
9. I 5.c.--<:-.4- UTILITIES ,.`',.'.7-r....-^11C-,, Public 0 Private
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 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
/a ft-/
DATE OF APPLICATION < SIGNATURE OF APPLICANT L-/-'"2 "V4 Mech.
k SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health (,. Heal IVy 7 SEPAPlanning "6,6 r 0 t‘ , c1� 11'" 7,, - 7I L?
_ u
Mobile Home J
Fire Marshall —
Co. E gineer Other (Specify)
NW/ �1 c2.
Utilities TOTAL $ �c
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
Bui ' g Ti ' n, PERMIT IS NONTRANSFERABLE �O�la}r� Ind, '8;�F 8�3 7.5.5 *5 0.0-0..2 0
_
(e. f C f
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL 1
1J
QQv •11 3'6'5VYds
3f3/7cl L f
t -
y r /�
r YGVPf�'`
dgc,-6-/lid ' `
441
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