1981, 04-20 Permit: 81A-3749 RemodelPLAN NUMBER.
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APPLICA'iON/PERMIT
SPOKANE COUNTY — BUfLDIN6 CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
E.. t/C&VD g -r4
LOT BLOCK SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3 I_Aal_ t-E-tUl..69pi
ADDRESS
PHONE
PARCEL NUMBER/S
2.2-54( - I33e1
ZIP
(o
Actual Set Backs in Feet
!Southa
Ls East a'S
North
West
CONTRACTOR
4
PHONE
Size of Parcel
Ivey t�3
Zone Classification
1Cl/tCTcA.t2h�c--
' ADDRESS
17-1 Zx b
4aze7
Type Const.
Occupancy
Z.-31�na
Sprinklered
❑Yes Ohio ❑ Req'd.
DESIGNER
PHONE
Valu ion
#15;840
Building Area in Sq. Ft.
•1 Zo
ADDRESS
ZIP
Main Floor
Upper Floors
-110
Garage Area
-720
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin_ Basement
TYPE
7. OF
WORK
NEW
BLD.
ALT.
❑ PLMB.
AD N.
❑
MECH.
❑ RPL.
❑ M.H.
O MVE.
O POOL
U 1 Htrt
No. Baths
I
No. Stories
No. Rooms
No. of Dwellings
1_
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not F;eq'd.
DESCRIBE WORK
. 1Irvrc.2con. Reatooa. 4 Alt4ca-tco 6-042A6.6
Enum. Dist. l Location (Area)
VALUATION
9. 1560
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
SE'PrtC.
Ownership
Public ❑ Private
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.ioSEE REVERSEypSIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION�F�� 6- T! I� SIGNATURE OF APPLICANT/�.�
SPECIAL APPROVALS
NAME DATE
-'Env Ith
1/6
Planning
Fire Marshall
o. Engineer
Utilities
Plans Examiner
"Tom POSTt .tarr,IJX/
SEPA Checklist
Buil ' g Tqt nician
SPECIAL CONDITIONS: w4,:Frt•V-.
AN dL To C-0psvRwZ' - -,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building Ofd
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 1t (•C-16
PERMIT NUMBER
yip" 7 1-9
02* *11600
* 11600
* 116006
A *0.00 0
3135
04z-06-8.1
-2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.�4jr�Z'9,�'81` 37492 *116.002-
PERMIT NO. Ti)T.=,L
DATE ISSUED
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