1981, 05-11 Permit 81A-4541 ShedPLAN NUMBER
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
1. , to51$
LOT BLOCK
2` 3 3
OWNER
3.
4.
5.
SUBDIVISION
tvk-E.fz l ` Pk0 tTtr�0
S't ti 4(..)i.D A '‘A.%-42q
ADDRESS
+r • t 51 i3 F EQii:� c 71 z.
CONTRACTOR
PHONE
CtZc:> ' 42D)
ZI P
GtC'tLCx..
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S 05 t_t-7O•3
Actual Set Backs in Feet
North (South (East'S, (West
Size of Parcel
145?C•'�'a
Zone Classification
ADDRESS
�.1—A01ryG
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
ADDRESS
PHONE
ZIP
Valuation Building Area in Sq. Ft.
t153G, Z 4-
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
kNEW ❑ ALT. !CJ AD'N. ❑ RPL. ❑ MVE.
LI BLD. ❑ PLMB. 0 MECH. ❑ M.H. ❑ POOL
DESCRIBE WORK
8 V(Tf —PI . *( O +a4DDiitohl TO avke.rk. E
VALUATION USE CODE
111I153G
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 I. regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO1S
io
DATE OF APPLICATION _ ( SIGNATURE OF APPLICANT
❑ OTHER
Area of Decks
No. Baths
Finished Basement
No. Stories
No. Rooms
Unfin. Basement
No. of Dwellings
CERTIFICATE
of EXEMPTION
SOURCE
OF
UTILITIES
SPECIAL APPROVALS
NAME DATE
GAS
Env. Health
Planning
n S
S7/1it/ i
Fire Marshall
Co. Engineer
Utilities
;17aminn[Se''rklist V "'
BuildiingTpclinician
ELECTRIC
SPECIAL CONDITIONS:
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership .�/
Public ❑ Private lis
Req'd.
Rec'd.
Not Req'd.
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
00
PERMIT NUMBER
glp.-4'34-i
02* *2600
*2600
*26006
A *Q00
454.0B
05-1 1 -81
2 611-79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 517 i' 1' r' 81
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
PERMIT IS NONTRANSFERABLE
4:541Z *26,001-2
PERMIT NO. TOTAL