1981, 08-06 Permit: 81A-7812 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT Al 614_--18Iz
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. ti.4(04 4:c11LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION ; P kRCEL NUMBER/S
2. Q a * * 17.00
OWNER PHONE
3. CA..4NTOi J L. &0.4 LLS Ste 53� 4fr3 * 1 7. 0 0 i
ADDRESS Actual Set Backs in Feet * 1 7, 0
0
Y
•4"'i '4TK qqz..exc, North 'South East
CONTRACTOR PHONE Size of Parcel Zone Classification(West A * 0, 0 0 E
4. SAME
ADDRESS ZIP Type Const. Occupancy Sprinklered 7 8 1.2=-'
4 #11/SIE ❑Yes 0 N ❑ Req'd. 0 8 - G 6-8 1
DESIGNER PHONE Valuation Building Area in Sq. Ft.
6 79,
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 NEW ❑ ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF ❑ OTHER
WORK
0 BLD. 0 PLMB. L"J/MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. ILocation (Area) ' FEES COLLECTED
8. 7.-Ei L'... i2.14K. Et RE--1A-420.g,
VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF Ownership USE CODE
9. UTILITIES Public ❑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
DATE OF APPLICATION(111, S+ SIGNATURE OF APPLICAN Mech. -00
SPECIAL APPROVALS a SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA n
Planning C)
Fire Marshall Mobile Home
ii
Co. Engineer Other(Specify)
Utilities
TOTAL $ I? tr.
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building TechnicianPERMITPERMIT IS NONTRANSFERABLE `0'8 �1&_l8'11 7.8 13 z *1700 ° -h -
9 h y c'7,`�0 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL