1981, 11-13 Permit: 81B-1775 ResidencePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY —,r 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,p(DRESS
I('2-(
LOT BLOCK SU DIV SION
2 I I�0yR Pl 1---r Apot-r.
OWNER PHONE
ARES fv`T'- 'I? -U �;
C, ?"aJC�> �'Iti' ' rr"� 2 CICU
CONNTItQGTQR HONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S O�4�I^ i :loe
Actual Set Backs in Feet
North South '.J East
Size of Parcel
1 lob
ADDRESS
DESIGNER
5' ADDRESS
6.
CHANGE OF USE FROM
ZIP
PHONE
Ti qe Gonst.
Valuation
ZIP
TO
TYPE
7. OF
WORK
CJ NEW
❑ ALT.
BLD. ❑ PLMB.
❑ AD'N.
O MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
IWest .;
Zone C assification
'i " -L; A '
Main Floor
r7 2
Upper Floors
Area Dec/k<.
6.70 G O v
No.<.Bahs
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Stories
2-
No,,00ms
Storage
Unfin. Basement
lLO
No. of1Dwellings
CERTIFICATE
of EXEMPTION
DESCRIBE WORK
8. j jr
9.
VALUATION
SOURCE
OF
UTILITIES
AS
ELECTRIC
WATER
SEWER
-'2-)t19-11
Enum. Dist.
ILocation (Area)
Ownership
Public 0 Private it/
Req'd.
Rec'd.
Not q'd.
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 local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION
IGNATURE OF APPLICANT
(,)
SPECIAL APPROVALS
NAME DATE
Env?,/filthy
Planni g
Fire Marshall
Co. Engin r
/'
Va/
3 1
Utilit s
Plahs trier
SEPAAChecklist
nicia
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)
7
TOTAL
$
PERMIT N.'JMBER
02* *337.00
*337.00
*337.006
A '*0.00
175,52
1'1-12-81
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
A.
DATE ISSUED
11
177.52 *1337.00 �-
PERMIT NO.
TOTAL
W
O
3
7o,
-1-
untPP isd
r 05'
0