1981, 04-30 Permit: 81A-4166 Addition PLAN NUM, APPLICATION/PERMITPERMIT NUMBER
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 Cit * * 5C,OU
1. r'. 1D617 15`x` LEGAL DESCRIPTION — SEE ATTACHED y C
rii
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. 1 1 iIUid castT'( 1-ketC,L1'T5 t ' 21543•-1ob 4 1 6.5
OWNER PHONE 0 4- 3 0-8 1
3. 1-1Poz.24 V i ie-6 41,24-213:50
ADDRESS nZIP Actual Set Backs in Feet 6 4 7 9,
E . iDS Ii IST H '/`ciNorth 42, JSouth East 'West
CONTRACTOR PHONE Size of Parcel Zone Classification
4. .�iltote 05 X 210.`� Ain(ZIL.btaucA(..
ADDRESS ZIP Type Const. Occupancy Sprinklered
5A.f11e ILA) j2-3 Oyes ❑No D Req'd.
DESIGNER PHONE Val tion Building Area in Sq. Ft.
5. r+,t3Ut7 217D
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
2bl
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. -
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
d/NEW D ALT. VAD'N. ❑ RPL. ❑ MVE. A I !
7. OF / 0 OTHER
WORK 51 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION J
DESCRIBE WORK Enum. Dist. Location (Area)
8. ADO TION S2.0 t0 e1) — i\Itn;[, �L. 2G0►M I FEES COLLECTED
I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership fdl USE CODE
9.141-.50d UTILITIES L6.Pr(— Public ❑Private
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 ti`D--
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 INSPECTION). ""ir, �^ / Plumbing
DATE OF APPLICATION / — atat ?' — ?1 SIGNATURE OF APPLICAN .%Lr/ i[/ffI Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: ,
NAME DATE Plan Check
Env, (ealth
�L.ez- �jo[O SEPA a.
P nning p
_ U
Mobile Home W
Fire Marshall
IT
Co. Engineer I. Other(Specify)
Utilities ^-?
• TOTAL $ C" ....)._____
39s7a finerWHEN MACHINE VALIDATED IN THIS SPACE,
ec st� THIS BECOMES A PERMIT.
B 'ding chnician PERMIT IS NONTRANSFERABLE 'I i 1' i >I O J -
O i ,�.l @', 8i1 4'16.6' *'S�4 0:0 a
'/ PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED ' ' PERMIT NO. TOTAL
1102,_ 7 (siz=. .
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