1981, 08-20 Permit 81A-8364 Addition of 2nd FloorPLAN NUMBER
f jp/ 4L/7
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
. N.
LOT BLOCK
2.
i. D EIZTb N
OWNER
3. J er-F.y
ADDRESS
N. Piz!
CONTRACTOR
R.oMD
SUBDIVISION
W. 001)NsoN
eft -TON IZoAD
PHONE
4z4-aS28
ZIP
`19X0
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 0651.143 36(6
1 OD OF E... 8 ` t)p 'TRACT �o '
017-c.0 IAFq) A Vg_.
Actual Set Backs In Feet
North ia:AlJ'r'south rat s-F
Size of Parcel
681 x /oo'
East -((Sr IWest f✓)(1ST"
Zone Classification
GA)ct,{US,
ADDRESS
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
ZIP
PHONE
ZIP
TO
❑ NEW 0 ALT. la -AD N.
CWBLD. 0 PLMB. 0 MECH.
DESCRIBE WORK
8. AP17tT(oN
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
(BGp%M, nfrr i FA► LY P.004
op S1J Np FLool2 To asiv lic.I
❑ OTHER
Type Const. I Occupancy
V-N R-3
Valuation
X/0zz400
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
Main Floor
Upper Floors Garage Area Storage
639
Area of Decks Finished Basement
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
Enum. Dist.
Location (Area)
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private
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 INSPECTIONS
DATE OF APPLICATION 5 " 8� SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
n
P nning
Ith
g/t
Fire Marshall
Co. Engineer
Utilities
P s Examine
SEPA Checklist• Cc C/iFCI7
SPECIAL CONDITIONS:
Not Req'd.
1 -
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
$
86 9-era-
TOTAL
$
PERMIT NUMBER
81 — 9-
02* *8600
*8600 17)
*86006
A *0.00
83632
08-20-81
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Buildi
Tech tin
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
•;,0!f8! -+' 0+!�- 81i 8' 3 6, 4 Z
DATE ISSUED ' PERMIT NO.
86,0.02l--
TOTAL