1981, 08-14 Permit: 81A-8206 BarnArrLR R I none rmnmu 1
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.
JOB ADDRES c.,),6c0VI I
LOT BLOCK SUBDIV SIONe''9C9r2- 1111
LEGAL DESCRIPTION — SEE ATTACHED
OWN
3.
QLD
PHONE
PARCEL NUMBER/S 1 4-y o r —
flau 7 7
t �Y�
112 r, 215
ADDRESS
.12--1
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
PHONE
ZIP
Actual Set Backs in Feet
North !South (East 7 !West
SizeofParcel
rjd 9,-V
Tve4onst. Occppancy
Zone Classification
�L S -
Spdfnklered
❑Yes No ❑ Req'd.
Valuation
�3pG-0
Main Floor
Uppe Floors
Building/�Afree-a in Sq. Ft.
Garage Area o Storage
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
t❑ ALT. 0 AD'N. 0 RPL. 0 MVE.
0 PLMB. 0 MECH. 0 M.H. 0 POOL
DESCRIBE W RK
8. tz'CiX
VALUATION SOURCE
OF
9. UTILITIES
0 OTHER
GAS
LECTRIC
WATER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Enum. Dist.
Ownership
Public 0 PrivAte
Location (Area)
L
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, rand 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 INSPECTIONS
DATE OF APPLICATION
,i
SIGNATURE OF APPLICANT Az-PLeea
SPECIAL APPROVALS
NAME DATE
Env. Health
&6A4
001
Planning
Fire Marshall
Co. Engineer
Utilities
PI s Examiner
IffetSEPA Checklist
B rild�ri
SPECIAL COe NDITIONS: I
A -1r J12V1YVIr(.r7 ,
S'ro►Z`1- cl% gra
�� .--, l sT 'r)
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Ijkq'
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 44
$�aA 6j'Zc7t''
02* *44.00
*44.00
82052
0.8-14.-81
2 6479
WHEN MACHINE MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
i jl 1
DATE ISSUED
821,6.1 *41100 _
PERMIT NO. TOTAL
�-
a
0
0
w
J
azV2. or- v2._ or 6, 2A- tAl -7-z I
r -r' -4
he7r,Tl ()hi l3' -.CC -1 7 7