1981, 07-08 Permit: 81A-6791 Residence.PLAN NUMBED
-7,9 3 5 L
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. 6., ,t)
LOT SUBDIVISION
2.
BLOCK
ADD ESS _ 21 (k
PHONE
IP
4.
CONTRA T R
,JotiN
ADC
DESIGNER
R ESS
11
5' ADDRESS
P
-IONE
A
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 1*?/I 9005
74- L-1' Off- �1
Actual Set Backs in Feet
North ISouthf'�.—
7 '� East 'West '_
Size of Parcel Zo a Classificati. n
I �vr7 x i ktgcIC
Sprin lered
❑Yes ❑No ❑ Req'd.
Type const.
Occu n y
TT
Valuatjorl
222,6
ZIP
6.
7.
CHANGE OF USE FROM
TYPE
OF
WORK
( BLD.
TO
❑ ALT. ❑ AD'N. ❑ RPL.
❑ PLMB. ❑ MECH. 0 M.H.
❑ MVE.
O POOL
❑ OTHER
Main Floor
WOO
Upper Floors
80
rea in Sq. Ft.
Building A
Gar gelA ea
Storage
Finished Basement
No. Baths' V No. Stories
No. Rooms
Un in. Basement
9 zb
o. of Dwellings
CERTIFICATE
of EXEMPTION
Req'cjl
Rec'
Not Req'd.
DESCRIBE WORI1
8.
VALUATION
9.
SOURCE
OF
UTILITIES
AS
ELECTRIC
WATER
CZNI
$EWER
Enum, Dist. I Location (Area)
I /
Ownership
Public ❑ Private
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 APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. ealt
Planning
Fire Marshall
Co. Engineer
Utilities
Plans E amine.
'Y
S P hcklist
Buudi
f
SIGNATURE OF APPLICANT
SPECIAL CONDITI S:
G1:2K1‹ UC- Vii '*
7 ,) /ate/y 2
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
02* *29800
* 29800
* 298.00
A *000
669.12
06-07-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,oTt!',1 81.8.1.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
679,15 *298.002
PERMIT NO. TOTAL
c
C
L