1981, 09-04 Permit: 81A-8922 Addition PLAN NUb.`2.FR APPLICATION/PERMIT PER IT NUMBER2..--
SPOKANE COUNTY — BUILDING CODES DEPARTMENT (A�
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
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APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOBADDRESS
1. �� �avp� LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIvSIO I PARCEL NUMBER/S
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/o� � -� Fi M D/�6 PFJ (-/, yv5glf�_ 7
3 ADDRESSq4T1 , Actual Set Backs in Feet C ft- ^ 1
` C/Q �f North 'South East
CONT Ile PHONE Size of Parcel Zone Classification - 6,11
a. ca x Iv-7 MLJ l ' �1- sJ�s-
ADDRESS ZIP Tpe.Const. Occupancy Sprinklered
h4l �ry�"' ❑Yes ❑No D Req'd.
DESIGNER PHONE Valuation y Building Tea Sq. Ft.
5' ADDRESS ZIP Man Floor Upper Floors Garage Area Storage —
422 --
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. •— _.
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
❑ Ew D ALT. AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER Req'd. Recd. Not R 'd.
WORK IIIll1X"BLD. ❑ PLMB. ❑ MECH. 0 M.H. ❑ POOL CERTIFICATE v
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) f
8 /� ` t*'1" IOI,l c 12-5 41)� FEES COLLECTED
VALUATION cOV lI
SOURCE GAS ELECTRIC WATER ���yyy�S�E��W�ER Ownership ,_.,/USE CODE
OF
9. UTILITIES '��G!I i K✓ Public 0 Private F�
' 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 —id _
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
'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
O
DATE OF APPLICATION 9- 3 — ( SIGNATURE OF APPLICANT ` ./e1-11) , Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Oro /\1 y1.c.-n.AI1
. Plan Check
Env. Healthli°f' Ir✓
- SEPA o
Planning U
— i,.1
Fire Marshall Mobile Home ..�
Cr_
Co. Engineer Other(Specify)
Utilities
TOTAL $
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WHEN MACHINE VALIDATED IN THIS SPACE,
SEP• heckli7 THIS BECOMES A.PERMIT.'
e:h PERMIT IS NONTRANSFERABLE :O'�(�r0-�'' iB 11 8 92 2 z *2 O.0 0 (IJ- -
dip PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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• ENGINEER'S CERTIFICATE •i 1 ♦i 1,-,-4, 4 _- Z
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I hereby certify that the above plat represents an actual sut!vey in thiA4rmade..1-
t
me 711 .' 1=0, ;that the improvements are on the premises in.ikon; 'that (n_
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there are no encroachments either w•a` across property lines and that there are,tno set ! Z
back infractions. r
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Except: N h e T