1981, 01-05 Permit: 81A-31 MHPLAN NUMBER
X
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. /731/S 64
q/1/1-e.---
LOT
A_S"
LOT BLOCK SU�
.n �-
2. ,3 C OQ v,Qdfj �'x�ta .1A -tee CaetPHONE
7j
3
4.
O NE�rR1� /// /,y// �7�
DDRESS
7 54/•0 S , (We-
CONTRACTOR
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
,CDT 8 LA-
APP,CE VA LL,E.J
.6--srA-7`,E.S . ND AD
ZIP
Actual Set Backs in Feet
North 4161 / (South
East /s (West '
PHONE
A.,. RESS
ZIP
Size of Pycel
70x_
Type Const. Occupancy
Zone Ciassificatio� ; D
,R2Ai �e�Vut /�/T.C�?i
Sprinklered
❑Yes ❑No 0 Req'd.
5
DESIGNER
PHONE
Val ation
as
Building Area in/Sq. Ft.
7.00
ADDRESS
ZIP
Main Floo,
7 OD
Upper Floors
Garage Area
Storage.
CHANGE OF USE FROM
6.
TO
Area of Decks
finished Basement
Unfin. Basement
TYPE
7. OF
WORK
NEW
0 BLD.
❑ ALT.
❑ PLMB.
q AD N.
0 MECH.
❑ RPL.
M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
l
CERTIFICATE
of EXEMPTION
No. ,. Rooms
Refd.
of Dwellings
Recd.
Not eq'd.
DESCRIB W RK
8. 141u
VAL ATI
��OURCE IT
IES
/
9./3004
UTI LIT
F
GAS
ELECTRIC
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership
Public ❑ Private g
USE 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 law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT! S
DATE OF APPLICATION /'" ' 'J
SPECIAL APPROVALS
NAME DATE
Env. .1- • h
a n
//i.
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu din pec nlciaryra/2
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
i
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home SA
Other (Specify)
04
TOTAL
PERMIT NUM13
07.* *50.00
* 5000
* 50.00
A *0.00 U
302
011 =05-81
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
1` *55`0.40.0,a e_ -
PERMIT NO. TOTAL
t
irri
far/75t2/iD i2 -K7
'"67 - 09
0/02b OL
-tpoicral .11
>1)2,1
0/.066
(')
aa
vz-9 bown/1
-DI(/ 10.1,101 >1D71`
4'
. 44.
r
rti=t..99
;3 4
4
33,
rf 3