1981, 09-29 Permit: 81A-9936 AdditionPLAN NUMBER
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
5.
LOT
OWNER
BLOCK
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION
t-vegaoto EisrArc s * 2—
ADDRESS
CONTRACTOR
%tnss
ADDRESS
E I®gob L{r 14 -
DESIGNER
PHONE
C(25— SO
ZIP
PHONE
T2-4 -81
PARCEL NUMBER/S
044L -v2 o ,
Actual Set Backs in Feet
'
North (South �zEast
Size of Parcel
c10x130`
rlt 8 "
(West
Zone Classification
ZIP
ggzoe
Type ••J
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
V lua ion Building Area in Sq. Ft.
Ce000 750
ADDRESS
ZIP
Main Floor
260*
Upper Floors
Garage Area
Storage
6.
CHANGE OF USE FROM
[INEW
❑ BLD.
7.
TYPE
OF
WORK
TO
Area of Decks
Finished Basement
Unf in. Basement
❑ ALT.
❑ PLMB.
IJO AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
❑ OTHER
No. Baths
0
No. Stories
No. Rooms
No. of Dwellings
8.
DESCRIBE WORK
Alootrao N -
VALUATION
7 SSV
EXT c (LIT, 9 TAtvziA.S �ivl
•
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not 5p2(' d
Enum. Dist.
Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private
USE CODE
I 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
to give authority to violate or cancel the provisions of any other state or •ca . egulating construction or the
performance of construct n. SEE REVERSE SIDE FOR REQUIRED INSECTI • S •,f
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
VEnv. Health
MAO
Planning
C\ 0,E5/6)
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
?Wilding chnician 17�'y�/jJ/�
SIGNATURE OF APPLICAIVT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBE,tt j
•
02* *62.00
*6200
*62006
A *C00 n
984,52
09-25-81
6,479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0:9i-'2'9='81
DATE ISSUED
993.65 *62OORO -
PERMIT. NO. TOTAL
S -r AOD26st— E 11406-4421
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