1981, 04-20 Permit 81A-3682 Demo ResidencePLAN NUMBER
#.20/e/
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
LOT 1 BLOCK
2.
OVNER
3. (Tel -/-641-e--ie
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
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SUBDIVISION
ADDRESS
//_�D ? /71
CONTRACTOR
' ADDRESS
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
DErSCRIBE WORK
8.
Ai/ A
VALUATION
9.
SOURCE
OF
UTILITIES
Location (Area)
No. Rooms
USE CODE
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H_r
ELECTRIC
PHONE
9*'" 7
ZIP
PHONE
PHONE
❑ MVE.
-C/vvl4l
WATER
OTHER
SEWER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
3/—/0Z
T d u<,V ,1 F 4 RD,L.,E"
Actual Set Backs in Feet
v u
North 'South East West
Size of Parcel / Zone Classification
Type Const.
Valuation
Main Floor
D�
Area of Decks
Occupancy
Upper Floors
S • r in klered
❑Yes DNo ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Baths No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private 92
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 INSPECTIONS
DATE OF APPLICATION •— 0 — c/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
:klist
c mc+aA
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Storage
Unfin. Basement
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /'D
02* *1000
* 10,00
* 10.006
A *0.00
368.1R
04-20-81
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 41t•- 2ia -+8 1 36 & 2 *' 1O. 0 0 -
DATE ISSUED PERMIT NO. TOTAL