1981, 07-28 Permit M81A-7490 AC(PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
M
PERMIT NUMBER
► - O
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
3
4.
JOB ADDRESS
276 //
LOT BLOC SUBDIVISION
OWN15R
ADDRE
e/
CONT ACTOR
MYR SS
/)i� "7C)7
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ZIP
PHONE Vt)7:)...
/4'9// 7()
PHONE
ZIP
TO
❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. _N'MECH. ❑ M.H. ❑ POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South
Size of Parcel
Type Const.
Valuation
Occupancy
East 'West
Zone Classification
Sprinklered
Dyes DNo ❑ Req'd.
Building Area In Sq. Ft.
Main Floor Upper Floors Garage Area Storage
Area of Decks
Finished Basement Unfln. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
DESCRIBE WOR
VALUATION
9.
1'zCAL' /e
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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 INSPECT hNS
DATE OF APPLICATION
SIGNATURE OF APPLIO�
Y�—
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
//AO
Other (Specify)
TOTAL $/ l 4C1
04* *14,00
* 14.00 v~i
* 1 4.000
A *0,00
74892
07-28--81
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED PERMIT NO. TOTAL
74 9, 0 Z * 1 '4' 0. 0 tO