1981, 10-21 Permit: 81B-0961 Residence IPLAN NUMBER I APPLICATION/PERMIT
irK/g- !1.)./ I , C)Ct 62 /
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
(di
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS Tit LEGAL DESCRIPTION - SEE ATTACHED
1 E, IAC
- LOT BLOCK SUBDIVISION PARCEL NUMBER/S * * '7' 00
2. 't i2 �,.'.L,i,...s� 1-l.-O"3 i Tt C:i
OWNER PHONE 9. 4„- I
Gi?.a.•-63k2 35 * 27rnCY
ADDRESS ZIP Actual Set Backs in Feet
14-c07— o4 t2.\4 North SC3 'South East Ct% West t +, * 1, ,,,
CONTRACTOR PHONE Size of Parcel Zone Classification E C 4
4. 1.a+rKe \b3.tm(o� ,,i- j,e` - 1(in^•1+_y
ADDRESS ZIP Type�py��Const. Occupancy Sprinklered 1 0-2 0-F' 1
Crry ��I-f`'' R3/M._i Dyes ❑No 0 Req'd. Fn Q.
DESIGNER PHONE V ation Building Area in Sq. Ft.
5. , 1741
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
1181 54::;,c, —
CHANGE OF USE`FROM TO Area of Decks Finished Basement Unfin. Basement
6. GO 1 i$3-) .
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE 0 ❑ 0
�NE) ❑v ALT. AD'N. RPL. MVE. 3 l i
5
7, OF ,�..�/ ❑ OTHER
WORK Ad BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not R�q'd.
of EXEMPTION t/
DESCRIBE WORK Enum.Dist. I Location (Area) T
8.Sit.-Ck Lts r Y►UL 12•-slt]tiVC C . E 401.14C -E MNO I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER „,,,/ USE CODE
OF Public 0 Private Q
' rjf�-'jf UTILITIES
. �'(lC- 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 at -xis.
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 I A•: law regulating construction or the
performance of construction.SEE REVERSEERQrSIDE FOR REQUIRED INSP: INS Plumbing
DATE OF APPLICATION 10 -B S SIGNATURE OF APPLICA , 4_ - Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. alth
_ C. �D/a l SEPA a.
P nning Q
U
Mobile Home w
Fire Marshall -�
Co. Engineer Other(Specify)
Utilities
1 � C h !!l���/// /1°. �l1 / TOTAL $9:Z8..tt
ans Examinee
/ WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buildin Technician
�
' "
PERMIT IS NONTRANSFERABLE —i2 It`yj8''l� 9 611 2 S.O F.
�� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
1
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