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1981, 01-22 Permit 81A-771 Repair Fire Damage
PLAN NUMBER PERMIT NUMBER 1A --77t CJ 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 E 40062 '1310A'DAAIno/ LOT BLOCK OWNER 3. A - If`t ADDRESS E. b JVtSUI V IJIoIV ryl UIVFOI • Rc CONTRACTOR 4 SArn E ' ADDRESS .3Aryl E DESIGNER 5. ADDRESS CHANGE OF USE FROM 6. TYPE 7. OF WORK PHONE qz) -14'13 ZIP G(ctZ.CDG PHONE ZIP PHONE ZIP TO ❑ NEW ❑ ALT. 0 AD N. gRPL. ❑ MVE. BLD. ❑ PLMB. 0 MECH. ❑ M.H. 0 POOL DESCRIBE WORK 8• RePAI P FitZE . AYh VALUATION SOURCE OF y h�� UTILITIES GAS ELECTRIC WATER ❑ OTHER SEWER SE�rtc. LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S fS©I or 'fz [SF E. 12. V .. EXC. 5, t(a5' g: EXC.. rRc-r TR. f,4 J& 14nntYtory 14r.543 1335 Actual Set Backs ip Fieatilm North South East West Size of Parcel Type Const. I Occupancy "1fi Z3 Valuation ( QDD Zone Classification Sprinklered ❑Yes ❑No 0 Req'd. Building Area in Sq. Ft. C.n nin Main Floor I Upper Floors Garage Area Area of Decks Finished Basement I No. Baths No. Stories CERTIFICATE of EXEMPTION Enum. Dist, I Location (Area) Storage Unfin. Basement No. Rooms INo. of Dwellings Ownership Public 0 Private Req'd. Rec'd. Not Req'd. 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 pre ume to give authority to violate or cancel the provisions of any other state or local law regulati constructi /r the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS DATE OF APPLICATION SIGNATURE OF APPLICANT{4'.4 SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist SPECIAL CONDITIONS: 4af_pL "cm. v vJ aLL_ R VLt4LIE 154111Q[x w. FLJ�tz_ FEES COLLECTED Single $ Building 17•, 00 Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 1-7 , 0C) 02* *17,00 * 1 7,00 i 77.02 01-22-8,1 z 6479 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. Building Technician PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE • .0-11;21'2: ,:8�11 DATE ISSUED 77;1Z *117.00R.g. - PERMIT NO. TOTAL