1981, 09-01 Permit: 81A-8788 Repair Fire DamageR 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
L6GAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
2. 3 �v 3�i v ►�� Ac.ecr�
OWNER PHONE
3. Sa -3-+a '2AtgQ ALi-
ADDRESS ZIP Actual Set Backs ineet
North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
4. 14c+z fA S t c 31.6 i -) 5.4%4r, L
ADDRESS ZIP Type Const. Occupancy Sprinklered
N. C)s M T -:x-a7 i3 V --:3S ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valtion Building Area in Sq. Ft.
5. `j a..--f—
ADDRESS
..__....—ADDRESS ZIP Main FloorUpper Floors Garage Area Storage
CHANGE OF USE FROMTO Area of Decks Finished Basement Unfin. Basement
6.
No. Baths No. Stories No. Rooms INo. of Dwellings
TYPE
❑ NEW ❑ ALT. ❑ AWN. VRPL. ❑ MVE.
7, OF�/ ❑ OTHER
WORK L( BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑POOL CERTIFICATE Req'd. I Recd. Not itp'd.
of EXEMPTION �/
DESCRIBE WORK Enum. Dist. I Location (Area)
$ � IA► ;r ` b FEES COLLECTED
VALUATION I SOURCE GAS ELECTRIC I WATER SEWER Ownership USE CODE
s i�OW UTILOITIES `�c'e"c'tG 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 Building tk0. c�
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
r/
DATE OF APPLICATION SIGNATURE OF ADD[ ICAKI-a) A I Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE R>✓P�ri2 E 1��MtAG.�
Env. Health i FtCc'nz_ �c�r,`� i E' O'?6ev SfA�2�r1E�t..
Planning
Fire Marshall
Co. Engineer
ns Examiner
nician PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 0-%
PERMIT NUMBER Q
02* *11000
*11r'.�0
*11000`
8767:_
0G-01-81
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
878.85 *11a00a�
DATE ISSUED PERMIT NO. TOTAL