1981, 06-16 Permit: 81A-9983 ResidencePLAft✓-WJMBL"R Y I
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
JOB ADDRESS
E.\[go\z
LOT
2. 2)
eve
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
SUBDIVISION
?i L f\m2A ?t u N£(73 1S T
3
OWNER
CSA q ll
ZuciA
ADDRESS
. 1017 -to
4
LOW.
fcAtzer
PHONE
42S -Z 4S
PARCEL NUMBER/S
offt - i4o3
ZIP
CIaZeiL
Actual Set Backs in Feet
North IOM 'South 61e
East 2-4 lwest
4.
CONTRACTOR
ADDRESS
PHONE
Size of Parcel
ICA X Z4$
Zone Classification
Stki.-1 LE ArntL'1
SL1ritc
ZIP
Type Const.
.IL/U
Occupancy
R-3irt-L
Sprinklered
❑Yes ONO 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
Val tion
Lib
Building Area in Sq. Ft.
i-1' i
ZIP
Main Floor
MIA
Upper Floors
130
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unffiin_. Basement
TYPE
7, OF
WORK
L.�JN E W
OU( BLD.
O ALT.
❑ PLMB.
❑ AD'N.
O MECH.
❑ RPL.
0 M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Stories
2
No. Rooms
q
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'tl.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.Glin61.1. FArmLv 2EstOE LE_ &f}0 -AME ACNEv
Enum. Dist. I Location (Area)
VALUATION
9. ,akin
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership„, USE CODE
Public 0 Private (
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 vi. :te or cancel the provisions of any other state or lo al law regulating const . 'on or the
performance of construe en. SEE VERSE SIDE FOR REQUIRED INS' IONS
DATE OF APPLICATION 1&%%/16 SIGNATURE OF APPLIC' -
SPECIAL APPROVAL
NAME DATE
fla4h,
/4
Planning
Fire Marshall
SPECIAL CONDITIONS:
Co. ngi er (SigG/CL-Ar � ,e/1-nr 4 �GL 7241 "6
1�Cac� PonIia \ (I'NeS � �
Plans
Examine " ) ste'
r`f-� _fI
ist
Utilities
hnician
1i1
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
$ 3b4.oO
rPE'RMH' NUMBER
02* *304.00
*30400
*304.006
A *000
335.0
04-10-81
6.479. -
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
598,32 *304.00a�
DATE ISSUED PERMIT NO. TOTAL
c
(Asir a
7SM P s-rtEwArrW 2I87