1981, 04-16 Permit: 81A-3593 InsertNUMBER 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 �
�, AADR LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PART F L NUV BER/S
2.
O NER PHONE
rj
3. /✓
DDRESS ZIP Actual Set Backs in Feet
9 ��,, 'yy� ' - , - North South East West
Cq,NTRACTOR PHONE Size of Parcel Zone Classification
1%
4' A!DRESS ZIP Type Const. rccupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor I Upper Floors Garage Area Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE ❑NEW IJ ALT. El AD'N. 1:1 RPL. El MVE.
7, OF ❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
❑ BLD. ❑ PLMB. MECH. ❑ M. H. ❑ POOL
WORK
of EXEMPTION
DE CRIBE W RK
/1 `// `/ A
Enum. Dist. Location (Area)
FEES COLLECTED
8. ��,�JCz'�"! f�-/'{_ �/t-ilii* „!
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
Q,
OF
UTILITIES
Public El Private ❑
Single $
1 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
��
Mech..�-
DATE OF APPLICATION' SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
ns Examiner
Building Teghniciap
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTA L /�f j
PERMIT NUMBER
04* *17.00
*17,00
* to -
1 700
A *000
359.2
Ola-- 1 6-81
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0141-1:6i1_'81 3''5 '9, 3 z
DATE ISSUED PERMIT NO.
*1Z00COL �-J
TOTAL