1981, 01-12 Permit: 81A-308 ResidenceNUMBER
1/-1a/sr APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOK<WP-, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
Joe ADDRESS
�. ( //3/e .3 7 a
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK ISUBDIVISION
PARCEL NUMBER/Sv�-i1.��G�7���_Cf�)g3
I
�
OW ER
PHONE
—
S
A DRESS
ZIP
Actual Set Backs in Feet
3
Iq q -V� 6
North -5d South ?41 East
West 1
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
.5 t34.
4' A DRESS
ZIP
T Const.
occupancy
USprinklered
N
a3rjL-1
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
V luaation
Building Area ink q. Ft.
DD
�
5'
ADDRESS
ZIP
Ma n81 or4,3
I Upper Floors
Garage Area
Storage
/
9A
—
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
i
Unfin. Basement
6.
/ �0
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwelling.
7, OF ❑ OTHER
BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist. I Location (Area)
FEES COLLECTED
8 /
V LUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
3�
OF
UTILITIES
V
Public ❑ Private
Single $
I here6y 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 I
regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTI N
Plumbing
/ Rµ
f1ATF OF APPI ICATIr1N / —L —?/ SIC;NATl1RF (7F APPI (CANT
/ L"
Mech.
SPECIAL APPROVALS
NAME DATE
le t!;
Planning
Fire Marshall
Co. Engineer
s txaminer
SPECIAL CONDITIONS: / / .LICE-Nez Df(� W
I✓36 ?,::9
�1.. -Vr SOI I�- :.�..'d/ /��/✓�,Q.-���aL � /?=1
st
nicia C.,{1,� PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ a/Z�
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
PERMIT NUMBER
—]
E,
j 0��
*31000 n
J 1 0. 0 0
n
6,479,
01112 81! 30, 8'z *310:`00a� -
DATE ISSUED PERMIT NO. TOTAL
'` N
3 7 Av�
PRa�ospn
R.ESlp�YGE
17'
1
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