1981, 08-31 Permit: 81A-8742 RemodelPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. - 2-0 '7-14
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2. 1
BLOCK
3.
51,4SION o I I]
I � h2»,,WWII � (T C)
OWNER
. . G7
PHONE
928'7 8
PARCEL NUMBER/S I;�j — 5c,I
AD Dg ES 5_2
ZIP
4.
CONTaTpR
PHONE
Actual Set Backs in Feet
North 'South [East (West
Size of Parcel
Zone Classification
ADDRESS
ZIP
TyWonst,
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin_ Basement
TYPE ❑ EW 'ViALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF / ❑ OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
DESC IBE WORK
s. I N'CWK1 ,
.DU RCE
• OF
9. UTILITIES
VALUATION
I I Dov
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not R d.
Enum. Dist.
Location (Area)
GA
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private
(g/6SE 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 la egulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT_ S
DATE OF APPLICATION — 1 — v 1 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Envaealth
vl
66c9117_
Planning
Fire Marshall
Co. Engineer
Utilities
Plan Exa iner
►e-15 V IQ*
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building 867,
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 8 6
PERMIT NUMBER
0744-z--
02*
744-2
02* *8600
*8600 i
*86.006
A *0,00
874,18
08-31-81
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'018'7 3` i'- 8 f
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
87422 *86.0Oa�-
PERMIT NO. TOTAL