1981, 08-25 Permit: 81A-8527 Insert PLAN NUMBER APPLICATION/PERMIT K
PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
G-.- NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. 1e;. ei �. -.1\ �� ___ LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMQtR/S
2.
OWNER PHONE
3. � 'v1\.fir ,— c_ `\
ADDRESS C \� ZIP Actual Set Backs in Feet 0 4 * * 1 7, 0 0
\r��-�`�� -' � \ o-�� �.,- ,, North 'South East IWest
CONTRACTOR PHONE Size of Parcel Zone Classification * 1 7.0 0
\---. 2 �� ,\ ,NC‘sc\ '6 '\ ��
* 1 7,0 0
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
• \'' \,N,\�\C`(1 < \�\ — �� d� Oyes ❑No 0 Req'd. A * 0 C;
DESIGNER PHONE Valuation Building Area in Sq. Ft.
852.6
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
08- 25-81
CHANGE OF USE FROM TO Area of Decks Finished Basement Unf in. Basement c, 6,4 7 9
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE 0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF — ❑ OTHER
WORK 0 BLD. 0 PLMB. IE MECH. 0 M.H. ElPOOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION
DESCRIBE W RK - Enum.Dist. Location (Area) '
$ --- ..\\`= ",---\\
4�`=� �A ���� I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership 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 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
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION !��(®� SIGNATURE OF APPLICAN ."k -—��r. Mech. _ /
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
:,--
SEPA
SEPA ^-
Planning
()
Mobile Home -'
Fire Marshall
Co. Engineer Other (Specify)
Utilities
A—7
/
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. *1 7'0 0 a
8 y, Z _
:uildi • Tech PERMIT IS NONTRANSFERABLE U'8 "'2 � 8 1
w PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL