1981, 01-19 Permit 81A-0618 Siding, FasciaAPPLICATION/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
2.
JOB ADDRESS
Io30q �3.rnodwway
LOT BLOCK SUB (VISION J
OWNER
3. QvIci B, .ILor--
ADDRESS 30q'BM (11.
CONTRACTOR
i' Icvcu,1 a1-hte 5 Cai*aC1D(3
4. AODRES iO`f' A-rgonyu koad
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
D NEW
BLD.
DESCR, : E,WOFFK
VAL ATION
9 'L J 15—I,Ob
❑ ALT.
❑ PLMB.
SO CE
OF
UTILITIES
TO
❑ AD'N.
❑ MECH.
O RPL.
❑ M.H.
ELECTRIC
PHONE
PHONE
PAT--
Z1�9 aol
PHONE
ZIP
❑ MVE.
❑ POOL
WATER
SEWER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 17 N 1- 4-F
K-r 1-2- 6,7 �c 1 2 1 e
6, 3/4,AU,
Actual
North
et Backs in Feet
'South
Size of Parcel
Type Const.
Valuation
Main Floor
Occupancy
Upper Floors
Area of Decks
No. Baths
'East West
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area In Sq. Ft.
Garage Area
Finished Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum, Dist. Location (Area)
Ownership
Public 0 Private 0
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
Storage
Unfin. Basement
No. Rooms INo. of Dwellings
Req'd. Rec'd. Not Req'd.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ilding TeFhnicl
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABI(
PERMIT EXPIRES ONE YEAR FROM DATE OAF ISSUANCE
FEES COLLECTED
Single
Building
?3lumbing
• Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
set, i t(')
TOTAL $. kLY)
PERMIT NUMBER
et A-- orol�j
02* *50.00
*50,00
*50,008
A *0.00
61.72
'01-19-81
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
4.
DATE ISSUED
618z
PERMIT 1O.
5 a or
T
T