1981, 04-30 Permit: 81A-4180 Special Inspect PLAN NUMBER APPLICATION/PERMIT C. , 3001Y14 PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
- 1l0
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
02 * * 800
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1. f..��112 Zl4D * 8 0 0 tii
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
* 800 x0
2.
OWNER PHONE r(
11 * 0. 0 0
3. LA aft ...361*0567•.. 9 Z4..?
ADDRESS /� ZIP .�/ Actual Set Backs in Feet 4 1 7.9
L. 4.`li L 2! Q 9ciZ(x, North 'South East
CONTRACTOR PHONE Size of Parcel Zone Classification 0 4-3 0-8 1
6479.
4.
ADDRESS ZIP Type Const. Occupancy Sprinklered
Oyes DNo ❑ 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 0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF WORK 0 BLD. 0 PLMB. ❑ MECH. ❑ M.H. ❑ POOL OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area) FEES COLLECTED
8. SW-Li AL. iftSPF'GTIC(J— GAt_i1#S ; SAFESY C.irNRIANZ.
IOF
VALUATIONSOURUE 1 GAS I ELECTRIC 1 I WATER SEWER Ownership I USE CODE
9. UTILITIES I Public 0 Private 0 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
C
DATE OF APPLICATION /io3O - d/ SIGNATURE OF APPLICANT '/'t Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE / _ �n Q '_�, Plan Check
Env. Health �fit4"11/Q / i-IS /4 . I I t� ',iv T/,--04.// t�`/\rola./-- pmts.
/�@2(4'1U��7 Tr) b is*. kir�v SEPA
a.
Planning L)
S)KO!<Ce ec7�
. � - Mobile Home - w
Fire Marshall
Co. Engineer 7A,/, /Lei,/-te / /Of a- s �N1 Alt Cii�.t Other (Specify) 0'00
/ u rj?''C-1-Ac. INS',
Utilities
TOTAL $ S,OO
Plans Examiner
i WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist �"(/L‘91-'4,4aeti..) THIS BECOMESYA PERMIT. ,
Building Technician PERMIT IS NONTRANSFERABLE ,0�4jk'1S' -111' 4 1 8.0 z �t&0,0 a I- -
5% `Z - PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE .
DATE ISSUED PERMIT NO. TOTAL