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1981, 03-06 Permit: 81A-2122 Addition
PLAN NUMB2R APPLICATION/ PERMIT PERMIT Nl1MBEf' { SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 0 2* * 1 0 4' 0 0 JOB ADDRESS 0 LEGAL DESCRIPTION - SEE ATTACHED 1. Coo. * 1 0 4. 0 0 10 4 0 0 LOT I BLOCK �- SUBDIVISION � PARCEL NUMBER/S ;.��r .a 2. - I1 �, O O O U 1]1 OW ERPHON 3. 2 0 TO ADDRESS ZIP Actual Set Backs in Feet oo North South Z" East West 030581 CONTRACTOR PHONE Size of P cel Zone Classification wq��d ;5--� ow - 6 4 7 9, 4. ADD ESS ZIP Type onst. Occupancy Sprinklered '+ ❑Yes ❑No ElReq'd. DES GNER PHONE Valuatign_ _C)o Buildin�a in Sq. Ft. 5' "_Storage — ADDRESS ZIP Main F*I Up eel lhrs 1� Garage Area CHANGE OF USE FROM TO A`rreeaa of a ks Finished Basement Unfin. Basement 6. TYPE �/ No. Baths No. Stories No. Rooms No. of Dwellings 0-'A ❑ EW ❑ ALT. i� AD'N. 1:1 RPL. ElMVE. 7, OF ❑ OTHER BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not 'd. WORK of EXEMPTION I DESCRIBE WORK Enum. Dist. Location (Area) FEES COLLECTED 8 VALUATION SOURCE GAS ELEC RIC WATER EWER Ownership SE CODE OF Public El Private 9. UTILITIES 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 DATE OF APPLICATION zkzSIGNATURE OF APPLICANT Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: // //{�{ NAME DATE "� � Kt_ Plan Check V ( ,Z'©1 _ "Y �C Env. ealth l fff SEPA a Planning Fire Marshall Mobile Home w --i Co. Engineer Other (Specify) Wf 04,�V, Utilities TOTAL $ ans Exam' IN THIS SPACE, WHEN MACHINE VALIDATED SEPA hecklisT THIS BECOMES A PERMIT. 0 3T 8 6 481 u T ician PERMIT IS NONTRANSFERABLE 1 21222" *104OOa► - ___ PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL