1981, 12-31 Permit: 81B-3079 Remodel PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
a V13 ?D
SPOKANE COUNTY - BUILDING CODES DEPARTMENT G� ;7
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 1 7. 0 0
JOB ADDRESS�� -7 114 LEGAL DESCRIPTION — SEE ATTACHED 0 � *
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
�Q- 2 c 7 3 0 7. 8
2. V4, I .<<1 c2 L'.• 91. (.21 c)f Iv11=l 1 i= 23 1 —8 1
OWNER VI A{ PHONE /Y ) JC_ �`
17<
3 ADDRESS f z5."03 ,2
Actual Set Backs in Feet
E;-- r 1 /I 3 17 North (South East (West
t PHONE Size of Parcel Zone Classification
CONT AC R
t....
4. ADDRESS ZIP Ty gonst. Occupancy Sprinklered
g,--2., Elves ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP Main Floor Upper Floors ( Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. No.Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ ryEW YJ ALT_ 0 AD'N. ❑ RPL. CI MVE. •
7. OF �/BLD0 PLMB. 0 MECH. 0 M.H. ❑ POOL ❑ OTHER CERTIFICATE Req'd. Recd. Not q'd.
WORK • of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area) ' FEES COLLECTED
8. kOIoirl NC�vo' /O
SE
SOURCE GAS ELECTRIC WATER SEWER Ownership ISE CODE
OF e'��r--111C. Public ❑Private L�7/
9, IC'eO UTILITIES Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included 12on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
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 Plumbing
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION / %- a / SIGNATURE OF APPLICANT
��'= 4�/' c� a, Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: .. = '1 ' -`'
.9' / v� Plan Check
Env. Health NAME DATE r--44-1' O`��. h1 . (40.,
1 4-ll 511--t,
1+ t, wrr, c.-2 2
`/TL L •L ) SEPA
Planning1•11OVer)Vrt - 'U
Mobile Home J
Fire Marshall
Other(Specify)
Co. Engineer
Utilities TOTAL $ 17
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist . i
,Buildin ec mifiani PERMIT IS NONTRANSFERABLE 1`2''--;� 1'"81' 3 0 7,9 z * 17. 0 0 d FJ-
_
/ - r PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL