1981, 03-09 Permit: 81A-2199 BarnPLAN NUMBER.-
3/9fir
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
F:0020 Ertl
LOT
BLOCK SUBDIVISION
OW.N.FcR
3. t % 6LIC) Pit20Eh1
ADDRESS
E. Iab2� T�
4.
CONTRACTOR
Gi+VIt E
ADDRESS
�Fi►1t>t
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
0 NEW
6(J BLD.
❑ ALT.
❑ PLMB.
PHONE
AZL -G'735
ZIP
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
El RPL.
0 M.H.
❑ MVE.
O POOL
0 OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S 6,L0f, iOF IivL si LF[,xj jr
Lvr` w h.. b
Actual Set Backs in Feet
North 'South (QCT,
Size of Earcel
East
751
West
Zone Classification
AGO_ccuLscc¢t�L
Type Const. 1 Occupancy
Sprinklered
Elves ❑No ❑ Req'd.
Valu tion
*2_, 7
Main Floor I Upper Floo
DESCRIBE WORK
-lbRG-I3ARiv
VALUATION
2.7 4
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
SE P7
Area of Decks
No. Baths
Building Area in Sq. Ft.
Garage Area
Storage
io
Finished Basement Unfin. Basement
No. Stories
No. Rooms No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private
Req'd. Rec'd.
Location (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
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
1,61
Co. Engineer
Utilities
Plans Examiner
1Jb-t 1ZEL '0
SEPA Checklist
Buildin�chnician
t✓�
SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
'55Z cis u.) k -c 1l Bina
itbe 4 1.2iPT1-Dur SL 4 5
r
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not?
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
1.3'.640
TOTAL
$ co
PERMIT NUM$EC,
02* *3800
*3800
*38006
A *0.00 0
219.8R
0'3=09-81
6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 '3j 81,
DATE ISSUED
219,95 *58,002 —
PERMIT NO. TOTAL
STu
's
N AtaG qe U
161.
65'
'33 '
1
R
L