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1981, 06-30 Permit 81A-6488 AdditionPLAN NUMBER / &iA 3,97 APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT PERMIT NUMBER NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES JO ADD RESS t11a? 5eoRDVJ/1- LOT BLOCK SUBDIVISION 3. 4. OWNER V A. A \z-IN5 ADDRESS I }p� J s, (..: � 1 Z� �3 1` 6 f�r. �-1 � r' CONTRACTOR �J� E ADDRESS DESIGNER 6. ADDRESS CHANGE OF USE FROM TYPE 7, OF WORK ,NJ,/NEW BLD. ❑ ALT. ❑ PLMB. PHONE ZZ-0-a`a3 ZIP }} PHONE ZIP PHONE ZIP TO 2r/AD N. ❑ MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S i�1 Ty Ni fQCp' CIF W `/ CDFT1-4.o FtrC: �➢,;;' 1C0s43-oPo Actual Set Backs in Feet North 4) 'South Size of Parcel o � East West ZQ� Zone Classification AeJ Type Const. Occupancy Val ion 4. 37c2 Sprinklered ❑Yes ❑No ❑ Req'd. Building Area in Sq. Ft. •so Main Floor Upper Floors Garage Area 1So Area of Decks Finished Basement Storage Unfin. Basement No. Baths No. Stories 1. No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. DESCRIBE WORK Enum. Dist. 8. ADD IT 3 oN Yo MCC" VALUATION SOURCE GAS ELECTRIC OF 9. UTILITIES WATER SEWER SCPTKI Ownership Public ❑ Private ❑ Location (Area) 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 UK) E SIGNATURE OF APPLICANT 1/�( Q� SPECIAL APPROVALS NAME DATE Env. HI Planning Fire Marshall Co. Engineer Utilities Cpllans Examin SEPA Checklist BuiJ�#+p t(/j/� hnician SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE Not Req'd. FEES COLLECTED Single Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 5C) .c 02* *50.00 *50.00 175 639.4� 0.6-26-81 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 181' 648.8z *503'0a1-2 - DATE ISSUED PERMIT NO. TOTAL tta L- i OPP 0 ATLI N11 TY 1 C. r" L. -9^ _JP Cc, 6 0 orw r N. 'TR 90 ° x0 1