1981, 06-09 Permit 81A-5670 Siding, Fascia4.
PLAN NUMBER
APPLITION/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
E • Broacikoc .
LOT BLOCK SUBCIIVISION
nI[
OWNER 0 tiLlf 1 °I VJ
3 C M-61 L. t-tiwl u k
ADDRESS
E . g '{- ).a Brc�a�u_lcc.ti
CONTRACTOR
rn e.v .0 Braiq't f3 ( ni-roti t-S
ADDRESS
DESIGNER iblo ArT)ncad
5.
ADDRESS
&/PHO4-
ZIP
PHONE
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S I' (} 4 -- o4c 1
Actual Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
DESCRIBE WORK
❑ ALT.
O PLMB.
❑ AD'N.
O MECH.
❑ RPL.
❑ M.H.
O MVE.
O POOL
xVALU/ATION SOURCE 1� GASG ELECTRIC WATER
9. 423b.a) UTILLITIESi
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. 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
Req'd.
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
I
PERMIT EXPIRES ONE YEAR FROM DATE 0 .SUANCE DATE ISSUED
Rec'd.
Not Req'd.
FEES COLLECTED
Single $LH" L)
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
" t TOTAL $ "'F .00
PERMIT NUMBER
02*
A
56692
O'6-09-81
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERAB
0�6;'9-81 56`7:iZ'
* 44,00
* 44.00
* 44.006
*0.00