1981, 01-13 Permit M81A-0430 Wood HtrPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
\ -0+30
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. 1Z224 in Off)
LOT BLOCK SUBDIVISION
OWNER
3. fib\( --V&A
ADDRESS
1= , rZ A 24
CONTRACTOR
4. AY11 C
is al Om)
ADDRESS
1/1-kmE
DESIGNER
rJ. ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
etzfo-"7C5ZS
ZIP
•
ZI
PHONE
ZIP
PHONE
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs In Feet
North South
East
Size of Parcel
Type Const.
Valuation
Occupancy
West
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
Main Floor Upper Floors
Garage Area
Storage
Area
of
Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
Mr NEW 0 ALT. 0/AD N. El RPL. ❑ MVE.
0 BLD. El PLMB. Q� MECH. 0 M.H. ❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
Not Req'd.
DESCRIBE WORK
8. (00012) BU 2N1!\-C
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist.
Ownership
Public 0 Private 0
Location (Area)
USE CODE
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
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
Dade,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. 4 CC)
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 17,0o
04* *17,00
*17.00 In
*17.006
A *0,00
42.92
01-13-80
z 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01,t13718,f;
DATE ISSUED
4 0 `z' * 17.0 0 4', -
PERMIT NO. TOTAL