1981, 11-06 Permit: 81B-1574 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
i`i ;2'/ SPOKANE COUNTY — BUILDING £BODES DEPARTMENT 8r6 -157V
0.01
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675DATEr APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES _, C 0
JOB ADDRESS1.
/, 6+2.9, /4LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S .;. 0 0 :‘_
2. ii 4 //alit./ vii,) Alois .;?n4 dd,'4IJ
/Y1
OWNER---� PHONE J�j3 _, o 4 l `.
3. �oluv t`c'�-£ -Required Set Backs in Feet
ADDRESSy) ,/Y ZIPQ �1 /
P,(y,�.Cjf. /3. '(?.s' .cck,Chtf/ /%213 North _I South3�' [East �4 (West 1•S'' 1 1 - ') 1i.- Y' 1
CONTRACTORe...71 PHONE Size of Parcel Zone Classification 6 47 9
o4rt i'd_k_F`4 e.3<I-(-lit ri2.� lO_Co . X '44-5- . Pk&.`- .AP.tA�Psr i)
4' ADDRESS / ZIP p Type Const. Occupancy? ( ryS�prinklered
p.�. 17X /3��� .�e� 99x. 13 Li& if-- Eves IXINo ❑ Req'd.
DESIGNER--�^ r j 1 1 0 (PAHO E/ /v/ Valuation / Building Areaeain Sq. Ft.
5. .1-Kd>r.proidc„...4.- Df^c1+C`Yfhl - 1.-:..1 w J 4 E 4 .-W3;rg�_ /76.11/
ADDRESS r ZIP DWL Area I Basement Area Garage Area -54eregg.
CHAN12 1. Lhdt'4, tel 99.�o7 IToso ` 7t� .` -748 ' ` ����
GE OF USE FROM TO Split Entry Split Level Rancher
6. X
No.Baths No. Floors No. Rooms� Rec. Room
TYPE
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. / y/ NO
7, OF ry� ❑ OTHER Req'd. Recd. Not d.
WORK E BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE q�
of EXEMPTION y
DESCRIBE WOR , FEES COLLECTED
8. 41cis. cls Source El/ A/ L �eite.,e-,
VALUATION
GAS ELECTRIC!- WATER SEWER
9. 10 W, `.° j Utilities Ri() td i„) {3 ,5E 1l 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 this Building �.CC
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 con tructi n or the
performance of construction. Plumbing
v
DATE ii -s - $1 SIGNATURE214 al Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. ) ✓✓
Plan Check
Env. alt /0 t`�(— 4_47555 (t 7 go f x
1 SEPA
Planni g LU
a_
Mobile Home
Fire Marshall
C2. .1 r lq-le Other(Specify)
Utilities ��`,J/ l -I LJl
TOTAL $ 5•1•`;".'' 'C).
Zone Clearance
2 �y WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist "ft/c�I/ II-9 -"I dOey
�/y� THISBECOoES'APPERMIT. oDATE I/,5�� OFFICIAL - e 1l1 UUUL 00 11 15 7.4 z *3 2 5, 0 aAPPROVED FOR ISUANCE
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