1981, 10-12 Permit: G81B-0556 DamperPLAN NUMBER 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
LEGAL DE:CRIPTION - SEE ATTACHED
LOT
BLOCK
UBDIVI ION
PARCEL NUMBER/S
2.
OWNER
PH N
��-03/
3.
ADDRESS
ZIP
Actual Set Backs in Feet
.S c,-, -&,,
{� /
�%��.p (o
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4.
ADDRESS
ZIP
Type Const.
Sprinklered
/,. )/tJ /.1.� , 4:414-4eotg*,z- T'
51,912V
FOccupancy
❑Yes ❑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 ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
WORK
of EXEMPTION
7Req'd.
DESCRIBE WORK
Enum. Dist.
Location (Area)
�1
8• t'✓S %La /% ��G7C d� t�+� /`r��v� rater' I �v%/t �/Tii l lu f'
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
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
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
DATE OF APPLICATION 3G SIGNATURE OF APPLICANT -'
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
�"" �� ,/��.yF,_ T !F�
5�
Plan Check
Env. Health
i,
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Utilities
Plans Examiner
Building T Inmcian` �' PERMIT IS NONTRANSFERABLE
V-1 I c 1 DCDIIAIT CVDIDCC r1NC VCA. FRr1M IIATP r1F ISSIIAIURF
Other (Specify)
TOTAL $ / y- C c
/ 1PERMIT NUMBER
li3 - o �5�
04* * 1 9,00
* 1 9.00 U
* 1 9.006
A *0,00 00
5515 �
10-1 281
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-12=81 55.6'
MATE MIZI Ir -n DCRhAIT KIn
*19.0'0 a� -
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