1981, 03-10 Permit P81A-2237 Soft WtrPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASH IN :-TON 951:60 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. r 9/ oL1 ' (? .t.k t-i'f
LOT BLOCK SUBDIVISION
2.
OWNER_
3
ADDRESS
CONT•ACTO4
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
ZIP
Actual Set Backs in Feet
North (South
East
(West
PHONE
Size of Parcel
' AD . • ESS
DESIGNER
5.
ZIP
Type Const.
PHONE
Valuation
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
❑ NEW
❑ BLD.
DESCRIBE WORK
❑ ALT.
PLMB.
8. 21,
VAL ATION SOURCE
OF
9. ` UTILITIES
GAS
❑ AD'N.
D MECH.
❑ RPL. D MVE.
❑ M.H. ❑ POOL
ELECTRIC
WATER
❑ OTHER
SEWER
No. Baths
No. Stories
1
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownersh ip
Public ❑ 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 ' —/
SIGNATURE OF APPLICANT
No. Rooms
Req'd.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
No. of Dwellings
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
,A-22.i7
03* *3,00
*300
*3,00'6
A *0,00 ES
223,5g
03-10-81
z 6479.
03* *200
*2.00
*2.00U
A *0.00 cp
223.62
03-10-81
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Building Technic' n
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
03:;-7Q-81
DATE ISSUED
223.7z *5.00aJ -
PERMIT NO. TOTAL