1981, 02-18 Permit: 81A-1596 FoundationPLAN 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.
LOT SUBDIVISION
H L���� 01110
2.
3.
BLOCK
OWNS 17J
ADD/R,E,SS �j r
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
o� "j-
11 5I 1,O1 r Y r
Aw LST T'
IP
Actual Set Backs in Feet
North 'South
East
'West
CONTRAtC.T�
4' ADDRESS
DESIGNER
5. ADDRESS
PHONE
97- C
Size of Parcel
Zone Classification
P
7
Typeilonst.
Occupancy
�l y
Sprinklered
Dyes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
021/BL
❑_NEW
021/BLD.
MALT. 0 AD'N.
0 PLMB. ❑ MECH.
O RPL.
❑ M.H.
0 MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Notfii'd.
�/
DESCo WORK
8.r/i4"I or `UIV {�I`r VR
G'
VALUATION SOURCE GAS ELECTRIC WATER
OF
9. 06 UTILITIES
Enum. Dist.
ILocation (Area)
SEWER
Ownership
Public D Private
USE CODE
I hereby certify that 1 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 dos not presume
to give authority to violate or cancel the provisions of any other state or local law regulating cuction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION ( i ( SIGNATURE OF APPLIC
SPECIAL APPROVALS
NAME DATE
Env. He Ith
Ilc1_ 16gf b .
Planning
Fire Marshall
Co. Engineer
14C9T RAVI n
Utilities
Plans E aminer
1tr71b-
SEPA Checklist
'ding Te • an Q
SPECIAL CONDITIONS:
CONi< L4C-, (' - of ri -1J - _ 1 l
-2-/14/o)
\
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
•
TOTAL
$ io •
PERMIT NUMBER
u2* *10,00
* 1 0.00 N
* 10.008
A *0.00 g
1 59.55
02-18-81
z 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0.2-1 8 +x'81.
DATE ISSUED
159.65 *10.00a� -
PERMIT NO. TOTAL