1981, 09-21 Permit: 81A-9615 Damper PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT tA -- 19
r, NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
V APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS RP/
E �/ y0 8' Z3 — LEGALDESCRIPTION — SEE ATTACHED 0 4 * * 1 9. 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. * 1200 17
OWNER PHONE * 1 9, 0 0 u
3. A • Gs iRak se 9aV-ei$ y3
ADDRESS AG/ ZIP Actual Set Backs in Feet N * 0, 00
// `7U7 •
eye,", P ,?-NE North (South East (West 9 6 1.4
CONTRACTOR `
PHONE Size of Parcel Zone Classification
Af` fCoi(4/./7 / ii(Z/cT iii-e- yoz-fr-a-lad 09- 21 -R 1
4' ADDRESS / ZIP Type Const. Occupancy Sprinklered
6 1? 774/ 7..m'/Gc...-a. -�G/ .4.--Y�_ 770Z-/}6 Oyes ❑No ❑ Req'd ! 6 4 7 9,
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.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
El NEW ❑ ALT. 0 AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER -
WORK
0 BLD. ❑ PLMB. 0 MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE/WORK ,e� Enum. Dist. I Location (Area) T
8. /,0645 frac </' P/4 to lee,K dN 444-arr. fAeslatea CA 1 FEES COLLECTED
VALUATION SOURCE G ELECTRIC WATER SEWEROwnersh i p ' USE CODE
OF
9. UTILITIES Public ❑Private 0
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
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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 Plumbing
it//ATE OF APPLICATION Y`--/4 �� SIGNATURE OF APPLICANT .i/. /! Mech. /0.0e9
'
SPECIAL APPROVALS SPECIAL CONDITIONS: ,fJ..d.��eft3 7e,
NAME DATE -/ 5 a ei e - e 7. it 4201 Plan Check
Env. Health (p
9 ///stii-/ �j(E--if."-i 47,L" -1SEPA >
Planning i
-
Fire Marshall Mobile Home -�a
Co. Engineer Other (Specify)
Utilities - 7/p
TOTAL $ / Oa
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
i, nn
:4101,... Tec d PERMIT IS NONTRANSFERABLE 0 91''2 i'. 8 1 9 6 1.5 z * 1 9' d -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL