HomeMy WebLinkAbout1981, 03-25 Permit: 81A-2761 AdditionPLAN NUMBER -
r- 6
3/as/37
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
1.
2.
3.
JOB)DDRESS
C—. '7 Cob 1"•
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
'. AU10 �o x Tor%
PHONE
PARCEL NUMBER/S LAY g"11 E.ZO of I.�Y 12
&Lc.iC S COO tzE 1aT . AvO•
24531 - •3205
ADDRESS
E ?nog 7Tt LE.io5o1 Trm)
ZIP
gAzor<.
Actual Set Backs in Feet
North 46 (South
East L‘(1 West
4.
CONTRACTOR
5Artg
ADDRESS
PHONE
Size of Parcel
It4b X 12Z
Zone Classification
2E5. Niot3fa 4itbME
ZIP
Type Const.
1LN
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
Va ation
Building Area in Sq. Ft.
448
ZIP
Main Floor Upper Floors
YA',41`,,6
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin.nf^inQBasement
TYPE
7. OF
WORK
fiA NEW
W BLD.
❑ ALT.
❑ PLMB.
Itp AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Rsq'd.
DESCRIBE WORK
8. A O'ITtDY "YO ReS ioEA cg
Enum. Dist. I Location (Area)
VALUATION
9$'i 3.44o
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
5E7P-it 6. -
Ownership �/
Public ❑ Private �p
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 INSPECTION
DATE OF APPLICATION -7—
SPECIAL APPROVALS
NAME DATE
Env. ealth
;/ 3
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
70/K Posit wP,IT 3/z5J8/
SEPA Checklist
Building Technician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building +104-.o0
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ tal-. oQ
PERMIT N i4fV7t3 E+R „
eibr
02* 4104.00
* 1 04.00
* 104,006
A *0.00
2760
03`L25-81
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
031-2i -81,1
DATE ISSUED
276.1'z' *104001 -
PERMIT NO. 1 _) I I
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