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1981, 09-02 Permit: 81A-8827 DemoPLAN NUMBER 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 1. LOT 2.51‘. OWNER 3. i eal:or.) ADDRESS E, tCaht`1 CONTRACTOR same ADDRESS SAMC DESIGNER ,GCqOG, tb114 LEGAL DESCRIPTION - SEE ATTACHED BLOCK t5 - SUBDIVISION LAU%) Q..e; IT-/ CrAce 4. 5. PHONE <ac..i_, on A ►ti. PARCEL NUMBER/S ZI P tri CN Actual Set Backs in Feet North South (East PHONE Size of Parcel 11Cxi5u 'West Zone Classification PSG. 6uz3O R- AAJ ZIP Type Const. Occupancy SCiL t2 ) Sprinklered Oyes ❑No ❑ Req'd. PHONE Valuation Building Area in Sq. Ft. Co CO ADDRESS ZIP Main Floor vv Upper Floors Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7, OF WORK ❑NEW ❑ ALT. 5%BLD. ❑ PLMB. ❑ AD'N. ❑ MECH. ❑ RPL. ❑ M.H. ❑ MVE. O POOL OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not yeq'd. DESCRIBE WORK VALUATION SOURCE OF 9. -0-- UTILITIES Enum. Dist. 'Location (Area) GAS ELECTRIC WATER SEWER Ownership Public ❑ Private N/ 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 APPLICATIOgJ Sey / 2) SIGNATURE OF APPLICANT71�% Z) %'�r✓1,41art SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Building echnician PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single �'$L$ Building `� 10,.20 Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ iii4CX PERMIT NUMBER 02* *1000 * 1 0.00 V) 88262 09-02-81 2 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 09,-0Z-81 DATE ISSUED 882,72 *10.0Oa(- TOTAL PERMIT NO.