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1981, 12-07 Permit 81B-2519 MHPLAN 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. G. J/Rzo MANSE)ELi7 SUBDIVISION LOT 2. ! / BLOCK s PA-c 77 OWNER 3. a��.S AN S M'4rr-r ADDRESS N _ LH ; M` PuNIACP CONTRACTOR 4' ADDRESS DESIGNER 5' ADDRESS 6. CHANGE OF USE FROM TO PHONE `fZ.2—o377 ZIP PHONE ZIP PHONE ZIP LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S o 75 44- 011-21 Pi NJIE.c 1?-4 T /120731 LE- NoM r/1R LIST S 'f 3- so Actual Set Backs in Feet North 'South Size of Parcel 51.0 pf5' x Type Const. Occupancy rL- 3 Valuation $ /60ooQom. Main Floor I Upper Floors Area of Decks East 'West Zone Classification N1 1-- -1 •FAIN 11,..y Sprinklered Oyes ❑No ❑ Req'd. Building Area in Sq. Ft. `780 Garage Area Finished Basement Storage Unfin. Basement TYPE 7. OF WORK D NEW ❑ BLD. ❑ ALT. ❑ PLMB. ❑ AD'N. ❑ MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER No. Baths z No. Stories CERTIFICATE of EXEMPTION No. Rqoms Req'd. No. of Dwellings J Rec'd. Not Req'd. DESCRIBE WORK s. jl�to iL }OME- GAS 9. VALUATION SOURCE OF UTILITIES ELECTRIC Cl`f' X "7o WATER SEWER Enum. Dist. I Location (Area) Ownership 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 SPECIAL APPROVALS NAME DATE Env. Health No-1- Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist SPECIAL CONDITIONS: FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL 00 0 Oc; $ 5O " vc yI , -zsiq 0,7 * *5000 *5000 ri 251.8z 12-07-81 o. 6,479 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. C c L L Building Technician PERMIT IS NONTRANSFERABLE 12-'07- 81 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED 25L:9g *50.002� PERMIT NO. TOTAL Mo -i . n bYNE 1'eYZG!