1981, 09-16 Permit: 81A-9425 DamperAPPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
l-/ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB, 1,3SS ` LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK SUBD VISION PARCEL NUMBER/S
2.
OWNER PHONE
ADDRESS
ZIP
Actual Set Backs in Feet
o
North South East
West
CONT ACTOR
PHONE
Size of Parcel Zone Classification
/'/ a1�-,4 / ZY 12W f r`c %� �.
is �- /o c-[--�
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
! /
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5' ADDRESS
ZIP
Main Floor
I Upper Floors
Garage Area
I Storage
CHANGE OF USE FROMTO
Area of Decks
Finished Basement
Unfin. Basement
6.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPE NEW El ALT. ❑ D'N. ❑ RPL. ❑ MVE.
7. OF ElOTHER
El BLD. ❑ PLMB. MECH. [IM.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
DESCRIBE WORK
�GF
Enum. Dist. I Location (Area)
FEES COLLECTED
8 . 4Z / 6, ev S lL'ti/i e- t" l4' P
G.,�e+ �`" -1
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
I UTILITIES
I
I
Public ❑ 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
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
r' �
Mech. %e. Z,'Z
DATE OF APPLICATION SIGNATURE OF APPLICANT i
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS: �7
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
dAl y,
Plan heck
SEPA
Mobile Home
Other (Specify)
TOTAL $ /`! G°Ct
PERMIT NUMBER
4e
4* *14.00
14 00
*14,00
A *0.00
9424
09-16-81
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6`-81' 94252
DATE ISSUED PERMIT NO.
*14.0001.0-
TOTAL