1981, 09-03 Permit: 81A-8866 ResidencePLAN N MBER APPLICATION/ PERMIT PERMIT NL,.ABEr'
�� 3 SPOKANE COUNTY — Bill<< DIF:33 CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
LOT BLOCK
2.
OW R
3.
21FSS �
2
CONT ACTOR
4. ADDRESS
DESIGNER
5. ADDRESS
APPLICANT:
COMPLETE NUMBERED SPACES -
PRESS
HARD TO MAKE 3 COPIES
Z
No. Rooms
No. of/ wellings
LEGAL DESCRIPTION - SEE ATTACHED
�U@qIVISION
El RPL. 1:1 MVE.
PARCEL NIUMBER/S
7, OF
ElOTHER
PHONE
M BLD. ❑ PLMB. 11MECH.
❑ M.H. ❑ POOL
l
3
Req'd.
I
y��
Not�q'd.
Actual Set Backs in Feet
r ,
'1.
of EXEMPTION
North South
East 15 West
D CRIBE WORK /
8. O>i i a �9l1.�dli�izli+D i . ���7 ! w ,
-/77-
PHONE
FEES COLLECTED
Size of Parcel
Zone Classification
U, X ,Z6
ZIP
T pe Const. Occupancny
ered
-Sp/U'n
❑Yes L�JNo ❑ Req'd.
PHONE
uation
Building Area in Sq. Ft.
ZIP
Main n
i�n Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. /31,0
TYPE
F1,�
No�aths
N Stories
No. Rooms
No. of/ wellings
Lf� NEW ALT. 1:1 AD'N.
El RPL. 1:1 MVE.
7, OF
ElOTHER
M BLD. ❑ PLMB. 11MECH.
❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not�q'd.
WORK
of EXEMPTION
t f
D CRIBE WORK /
8. O>i i a �9l1.�dli�izli+D i . ���7 ! w ,
-/77-
Enum. Dist. I Location (Area)
fn ��^�
FEES COLLECTED
VHLUHI IVIV SOURCE �AS ELECTRIC I WATER I SEWER Ownership LL USE 7CIDE
Q UTILOITIES Public ❑Private...6 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 43c'] CC)
•�
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 ating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTI� OI9S I^ Plumbing
02* *3C 1.00
*3C 1,00
*3C 1,006
A *000
8,6742
08;28-81
X479:
t
DATE OF APPLICATION Z y / — SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
En hkro` "C / yg-,-j1
SEPA C
Planning G.
LL
Fire Marshall Mobile Home
LL
Co. �jgiin Other (Specify)
Utilitie
TOTAL $ 3d
Plans Examiner
i
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
BuMig chnician PERMIT IS NONTRANSFERABLE�O':,{�';.• r�'_ 8 1 8 8 6, 6 z* 3 0 10 0��
�PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE 1S§lJED PERMIT NO. TOTA'