1981, 10-21 Permit: 81B-0957 ResidenceUMB7R 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
JO ADDRESS/�,
`�IT'
LEGAL DESCRIPTION -SEE ATTACHED
1. r 100;z4a
LOT
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PARCEL NUMBER/S
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OWNE 11 /
PHONE
3.
ADDRESS�/ ]
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%�
Actual Set Backs in Feet
^7
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North :S South East
West /
CONTRACTOR
PHONE
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Siz of Parcel Zone ,Qfassification
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4.
ADDRESS
ZIP
Typ onst. Occu an y
V
Sprinklered
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❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation- 2
'7
Building Area in Sq. Ft.
!
5.
ADDRESS
ZIP
Min Floor Upper
Floors
Garage Area
/
Storage
_3OCd
goo
'1
CHANGE OF USE FROM
TO
Ar of Decks
Finished Base ent
Unfin. Basement
6.
TYPE L�NEW ❑ ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
No. Baths
No. Stories I
No. Rooms
I
No. of 7wellings
], OF ❑OTHER
BLD. ElPLMB. ElMECH. ElM.H. El POOL
CERTIFICATE
Req'd.
Rec'd.
Not d.
WORK
of EXEMPTION
DESCRIBE WORKEnum.
8 C<1
Dist.
Location (Area)
FEES COLLECTED
VAL ATION
SOURCE
OF
GAS
ELEC RIC
WATER
�e�7S SEWER
Ownership
USE CODE
Q.
V( 1 t�
Publ ic El Private ef
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'3�
1
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 INSPECTI
rNATC nr ADDI 1f'A-rl r1/it:qE (7/98 CI(]AIATI IRF f)F APPI
NS
Plumbing
Mech.
SPECIAL APPROVALS
117 NAME DATE
riy.fXea
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e Me �
anning
ire Marshall
o. Engineer gg
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tilities
�X SPECIAL
'—
CONDITIONS:
an�C—,..Q PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (SpecifvJ�_
PERMIT-NUMBERC
r
* *_2`rt00
*_2'001
10-G6�81
6479.
TOTAL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE'�SSUEDIjo e� PERMIT NO. / Z *3 2 5. 0 AL
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