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1981, 03-03 Permit App: 81A-2012 ResidencePLAN NUMBER e - • /f- BMA -67 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 44 1. 2- LOT BLOCK 2. • osPAls,1 SUBDIVI ION 3. OWNER , as 6,612,riJ ADDRESS 4. CONT CTOR ADDRESS HONE `!__ ZIP PHONE LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S�' I� �553 PO Cr N, Il0, 4� or �, or Lo -T I'�, L'oOK 17 G�74o-, Actual Backs fn Feet („ North 'South 1'2—LEast .3 'West DESIGNER 5' ADDRESS ZIP PHONE Size of Parcel rr X 1 0 Occupi ncy Typo Cronst. Valuation f? 000 Zone Classification Sprinklered ❑Yes No ❑ Req'd. Building Area in Sq. Ft. ZIP 6. CHANGE OF USE FROM TO Main Floor 1' Upper Floors IIr jet t.ea 1"'(o serw Finished Basement"' Area of Decks elrage TYPE 7, OF WORK ❑ ALT. ❑ AD'N. ❑ RPL. LJ BLD. VPLMB. ❑ MECH. ❑ M.H. ❑ MVE. ❑ OTHER ❑ POOL No. Baths No. Stories No. Rooms Unfin. Basement 1176 No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not. Req'd. 8. DESCRIBE WOIRK VALUATION SOURCE GAS LECTRIC OF 9 Llj{U_ 6�&3;-- UTILITIES Enum. Dist. 'Location (Area) WATER 471,jraCjV� SEWER hereby certify that I have read and examined this application and have atl 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 INSPECTIONS DATE OF APPLICATION ( 9Y7SIGNATURE OF APPLICANT ` ti' t'dt C Ownership Public 0 Private ire USE CODE SPECIAL APPROVALS NAVE DATE nv. ea 6113/2 Planning Fire Marshall C E g er 3/0Vgi Utiii ies Plans Examiner ail pOS- W,j7 3)3 ) SEPA Checklist •pian SPECIAL CONDITIONS: Ov )1(-- ti4)01 Ht+aNA J,»3/ A4411sthit I i�•I,�.�1I a2x. jk �e r, �,� xJ, J 3I I\4101 01A16a PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE tcf FEES COLLECTED 1 Single $ Building !�' n e' Plumbing Mech. Plan Check SEPA �jG I M..L�ilcLFlome °C7 Other (Specify) TOTAL �044,I,6o ✓f ...gyp PERMI I FUMBER SIN-Zo>t2 02* *8000 *8000 *8Q006 A *000 8 193.42 03-02-81 z 6479, 03* *21,00 *21.00 N 19352 03=p2-81 2 6479. 07* *10000 *100,00 N 19362 03-02-81 z 6479 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 05'41)1 78 DATE ISSUED 20122 *201:000 - PERMIT NO. TOTAL 175' bh i a5 �`\� 5. .6' n� Ki . IG9, 45, CP N . l ,21 9 ' or- L; f 172 p, q [1 , ce,r-,il I N A10. '0,6114a Pic. zcAO •