1981, 08-13 Permit: 81A-8108 Residence NUMB ,_ APPLICATION/PERMIT PERM";NUYIBcR
I it t , 4d;" SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 I p^ g10iri
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
1 LOT a ILO K SUBDIVISION �` PARCEL NUMBER/S ��r7 .,4, _ 0 2 * * 2- 1 1,0 0
2. Z ��vloJ Ai2bl"ro► � * 211.00
OWNERHO E
3. I7I\✓ {�j sl t1 rlo .- pri l 7 +— 7 7 2 2
ADDRESS ` ' ZIP Actual Set Backs in Feet
I r I12"- V I I I N' II _2_6;6
North ,3 U ISouth 2•r7 East -"-- (1:=-7 IWest 2 0 8 L 3-8 1
COWcoWOR ONE Size of Parcel I27ZoneClassification f g. 6 Li.79
4' X
ADDRESS ZIP Typ 1�onst. Occu ancyt Sprinklered
1 �� } PIV� ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation /I! Buildin rea in Sq. Ft.
•
5' ADDRESS N pr
ZIP Main Floor Upper Floors GaArea Storage
t —
CHANGE OF USE FROM TO C/Arteeaa ooff?Decks Finished Basement�JUnfin, Basement
6. ._ —
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
W ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7. OF ❑ OTHER CERTIFICATE Req'd. Rec'd. Not .d.
WORK LLL��� BLD. ❑ PLM B. 0 MECH. 0 M.H. ❑ POOL v
of EXEMPTION
DESCRIBE WORK Enum. Dist, I Location (Area)
8 9� c , I i Cl FEES COLLECTED
VALUATION ►/� `'�I` ECT• I
SOURCE GA ELECTRIC WATER �SEWER Ownership /USE CODE
OF
��
9. UTILITIES I Public 0 Private
C�
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 thisBuilding 7—.1 I
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 I. , kegul. ' g . structi n or the
performance of constructio SEE REVERSE SIDE FOR REQUIRED INSPECT!, ‘ (T. ,,
Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICANT Ie: 1 Mech.
SPECIAL APPROVALS CIAL CONDITIONS.
NAME DATE Com•)( ,/ `�kF�`— .� t Plan Check
En . ealt „/n „"1 j- VV..(r ~V� 2 / 7oo) Io/ .7/
�et LL - / 02 LP7 •J (zi 1.43 Ki) SEPA
Planning U
Mobile Home '_
Fire Marshall a
Co. gineer Other (Specify)
Utilities TOTAL $ 2 I I
,Plan
WHEN MACHINE VALIDATED IN THIS SPACE,
PA Ch-cklist lt
/ THIS BECOMES A PERMIT.
:u .g ec� ian PERMIT IS NONTRANSFERABLE Q'8' � 81 a8 z *211.0020
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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