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1981, 04-07 Permit: 81A-3202 Fire Damage Repair
PLAN NUMBER 4/7/V APPLICATION/PERMIT SPOKANE COUNTY - BUILDING -CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 JOB ADDRESS 1172-16 APPLICANT: 6- 71r4 COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES LEGAL DESCRIPTION - SEE ATTACHED LOT 2. BLOCK SUBD VISION, 12C �L� ►2�T Aoorr 3 OWNER ADDRESS t� 132-1 3 6- PHONE 951-16I PARCEL NUMBER/S -•2-r--;,11--. zr� 4 1- 110(4? 1©(o Actual Set Backs in Feet North 'South East (West CONTTRRAACT R 4. ADDRESS PHONE Size of Parcel ZIP g C' 7c11 3� Tyge onst. Occupancy v ftVl Zoe Sprinklered ❑Yes ENO ❑ Rec'd. DESIGNER 5' ADDRESS PHONE Valuation Building Area in Sq. Ft. ZI P Main Floor Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK 0NEW Ig/BLD. 2 ALT. ❑ AD'N. EIRPL. ❑ PLMB. ❑ MECH. ❑ M.H. 8. DESCRIBE WORK ri K ts, c2A. VALUATION 9._;O� Mi JAIi4 4 SOURCE OF UTILITIES GAS ELECTRIC ❑ MVE. ❑ OTHER 0 POOL v1 No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not q WATER SEWER Enum. Dist. Ownership Public O Private ILocation (Area) ,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 INSPECTIONS � `" DATE OF APPLICATION '! r / �/ SIGNATURE OF APPLICANT G �.4"1-z'' SPECIAL APPROVALS NAME DATE Env. Health KtorC Ka?iv - Planning Fire Marshall Co. Engineer Liar 1 Utilities Plans xaminer 10 SEPA Checklist ec n ian r SPECIAL CONDITI NS: I PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 10' PERMIT NUMBER 02* * 1 0.00 *10.00 V) 320.1§ 04-07-8,1 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 04,-07-'81 320.2i *10.00 °a - PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL