1981, 04-03 Permit: 80A-3090 Residence PL"N NUI+ ?ER UMBER
APPLICATION/PERMIT PERMIT N
FM- i i w /o SPOKANE COUNTY — BUILDING CODES DEPARTMENT ,fe d -3 d zID
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
''�4.)7/ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS * * C Jr C`.. L
i. r'' / .7.Z.e) '1T/ 7 �✓� 4� LEGAL DESCRIPTION — SEE ATTACHED .6 1: 0
LOT BLOCK 'SUBDIIVISIO PARCEL NUMBER/S *r ,Z
* C .
2. E. /3e`OF CDT E ��K„ 1 � GX�e-,.- iJ��
iRONE) r���COie✓ 4 � 5. Ti)Tv� z JN F � l * i . ,
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F',
3. X...W.. N.. ,1 v,t-e ) 9-2Z_ir? 7
ADDRESS .�/ L ZIP Actual Set Backs in Feet z 3 V y
J ?+d>4,,2-.4 /4//.>Z✓U./�I,(-f t-, i✓yZ-Gys(.,�1 e / 99/)/(E% North 64 1 South .Z.5-----5- f
East ' / IWest$2 0 4=O 33-E,•
1
C NTRACTOR / PHONE/eV Size of Parcel ! Zone Classification
,.eP�! , //,��/ 773—5.;I:).3 /°.!1/ x•„ 4 4 la<.({'I ✓. Al. 6 'a 7 9.
4' DDRESS .7,- / Li� /`\ (&"i,.('_ ZIP i Type Const. Occupancy Sprinklered
A ?/ I :j ❑Yes ❑No 0 Req'd.
11 DESIGNER PHONE V Iuaation / Building Area in Sq. Ft.
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO cats ,r o,f Decks/ Finished Basement Unfin. Basement
6. . poIran t. 11_3 6.6.,
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE El NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE. "
al I /` 6
7, OF 1+� ❑ OTHER
WORK aBLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION K
DESCRIBE WORK Enum. Dist. I Location (Area) FEES COLLECTED
8. ,./.r�,-i ..�...j./.1.4.2, Z�� 4.D.�d l,�i_. 1-4-- I
VALUA ION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
9' 40; L t--UTILLITIES Public 0 Private igSingle $
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 .Z,6"-.6 .._.e)2_
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 INSPECTICNS Plumbing
u (-----;(7t Mech.
DATE OF APPLICATION -1f/` �` i SIGNATURE OF APPLICANTLA-4° '
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env H aI
V Xtele-el /1°,;,Z, SEPA r
Planning n
Mobile Home W
Fire Marshall
i
i )e l FIO C. Ail RA(.1r 0 A/4—E0 5 ✓ti ,q=o/=/e2.AmsAe/
Co. Engineer Other(Specify)
V 0 F wA-%k/NG r / A./c,e. V,
Utilities „..,. e.0TOTAL $ '- '
Plans Examiner
-NM Po arra40417 / WHEN MACHINE VALIDATED IN THIS SPACE,
V SEPA Checklist THIS BECOMES A PERMIT.
Bui}ding'y/ ecpnici � PERMIT IS NONTRANSFERABLE 0 1 1 ,017'8'1' 3 0 4 0 2 *2 5 6,0 0 °a F-
k/ 4a ,',a,,yi-/A , PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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