1981, 05-05 Permit: 81A-4372 ResidencePLAN NUrnBER .
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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
1.
2.
3.
4
JOB ADDRESS
�. a-019 3I �I{
LOT B LOCK SUBDIVISION
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OWNER
a�''� M0(2(>--6zl
.,� ,• �l L..1 � K1 K,
Uld
CONTRACTOR
�JAM6
r
ADDRESS
SAM£
DESIGNER
1400
PHONE
, -fit
ADDRESS
C"Z W
PHONE
ZIP
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
335�I-i 16+
Actual Set Backs in Feet
h . 1 *
North Z_�9i South 0 East West 10
Size of Parcel Zone Classification
SS X I�iJ � ilkG.l- FAY&UL_-j
Ty�onst.
Occupancy
IZ-3/M„I
Sprinklered
❑Yes ❑No ElReq'd.
luation
4-%,435
Building Area in Sq. Ft.
6-q
5'
ADDRESS I
ZIP
Main Floor
tibio
Upper Floors
Garage Area
529)
Storage
CHANGE OF USE FROM TO
Area of Decks Finished Basement
Un in. Basement
i 69
6•
No. Baths
No. Stories
No. Rooms No. of Dwelling
TYPE �] NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 3 1 lo 1
7, OF iEIOTHER CERTIFICATE Req'd. Rec'd. Not fteq'd.
WORK u BLD. ❑ PLM B. ❑ MECH. ❑ M.H. El POOL of EXEMPTION V/
DESCRIBE WORK Enum. Dist. Location (Area) FEES COLLECTED
8. FAWtL ( (,6SMF-VU6F- &AefV-,C USE CODE
VALUATIONI SOURCE GAS ELECTRIC WATER SEWER Ownership
9# 4-jl +!)jjjj UTIOFLITIES yJ 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 Building r
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 Plumbing
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
/ / a Mech.
clrK]ATURE OF APPLICANT ��� �
SPECIAL APPROVALS SPECIAL CONDITIONS: V �4�
LiLF- e,& 7 It'll o
Env. Health
NAME DATE
�l-i�N� n-.�'T�(%�lyft% �'%'• �yfSlli�S ��'" T�O
Planning
Fire Marshall
Co. Engineer
CS
Utilities
Plans Examiner 5
.� S . �- /1
SEPA Checklist
Bu�nechnician �n PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ Z'7
PER .AI , NUR•:B—ER
,L* *274.00
74C
*2 74.00'
A * (} t
.77,50
4-21
6479. -
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0`5 "5,
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a
DATE ISSUED PERMIT NO. TOTAL
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