1981, 01-27 Permit: 81A-884 MH PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
7/g/ SPOKANE COUNTY — BUILDING CODES DEPARTMENT 8/A -8' 1
0 ' NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED 0 * * 1 0 0.0 0
'./1//4" _ * 1 00, 00 v,
LO BLOCK SUBDI ISION PARCEL NUMBER/S
1/ ti5,1 `� i.i * 10000
OWNER HO E or.
o,-I vf2 �� SIO/ �'r A * ri 0 0 i
lid
ADDRESS FZIP Actual Set Backs in Feet
8 8 3 c177 Ar �iC1', i '/kr ®jNorth 'OBS (South Eas/C2 IWest
COMT PHONE
Size of Parcel Z ne Classific moon i 0 1 —2 7—8 1
4. OZIP Type Const. Occupancy Sp inklered 6.Q i 9.
/V /,Z-5 ❑Yes ❑No 0 Req'd.
DESIGNER PHONE Valuati d', BBuilding Area in Sq. Ft.
O I
5. /
ADDRESS ZIP MainIobrOO UpperFloors Garage Are® Storage
CHANGE OF USE FROM TO Ar4aao Decks Finished Basement Unfin. Basement
6.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE. /
7, OFl/ ❑ OTHER -
WORK 0 BLD. ElPLMB. ❑ MECH. IJd M.H. CIPOOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION X
DERIBE WORKEnum.Dist. Location (Area) T e
8. 1" °�1 I Imo, )( & -:.) 1
I FEES COLLECTED
iV�AQIL,UATION SOURCE l�G(AS ELECTRI WATER SEWER Ownership ,..,//USE CODE
9. 1 (J UTIOF
LLITIES � Public 0 Private pc/USE
Single $
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 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 INSPECTIONS Plumbing
DATE OF APPLICATION 7 7 7'=" SIGNATURE OF APPLICANT S/� ` '�' _,;1:,-?-,----‘.' Mech. _
SPECIAL APPROVALS SPEIALCONDITIONS:
NAME DATE
15
yfl/1V i \ro / cr lJ/r ff-i5
-11-V4•1 MIN],
Plan Check
Eth ia. r 1 v-
/7. _z._ SEPA >-
Planning ti 5"v` l (' 1/ 'rt4°) 917 ,./r''���] �� — O
IV� - U
Fire Marshall Mobile Home '�
VSE —.2-2 6.-S d - - :�%�-/.�,�.1�,��;c . a-� u
Co. Engineer Other(Specify)
Ca.A: .-/- /-g,O 134,-"Ata)/45-452,A714) le.a.T. , 0
Utilities �Q,� et/04'.4L'+��'-e- TOTAL ld
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Al 4' —
,r �g/ician r PERMIT IS NONTRANSFERABLE U'1 -2'7 _.'8 1` 8 8.4 z *1 0 a kgoOJ
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO.