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1981, 11-09 Permit M81B-1641 Wood InsertPLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456.3675 JOB ADDRESS �- , 1 � 56*I 55 LOT 2. APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES BLOCK SUBDIVISION OWNER 3. 6L,erViV (1cDtz-tIVs ADDRESS E • f503 (IA ISS tovi CONTRACTOR 4. S f-Mj 5' ADDRESS ADDRESS DESIGNER CHANGE OF USE FROM 6. TYPE 7. OF WORK PHONE ZIP Q etO PHONE ZIP PHONE ZIP TO VI NEW 0 ALT. 0 AD'N. ❑ RPL. ❑ MVE. ❑ BLD. ❑ PLMB. 11/MECH. 0 M.H. 0 POOL DESCRIELE WORK 8. iAJCXjD3(...tRAN fk) Ct VALUATION 9. SOURCE OF UTILITIES GAS ELECTRIC WATER 0 OTHER SEWER LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S Actual Set Backs in Feet North Size of Parcel Type Const. Valuation Main Floor South East Occupancy Upper Floors Area of Decks No. Baths Zone Classification Sprinklered ❑Yes ❑No ❑ Req'd. Building Area In Sq. Ft. Garage Area Finished Basement No. Stories CERTIFICATE of EXEMPTION Enum. Dist. Location (Area) Ownership Public 0 Private 0 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 ( (. SIGNATURE OF APPLICAN No. Rooms Storage Unfin. Basement No. of Dwellings Req'd. Rec'd. SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist SPECIAL CONDITIONS: Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. 4'11 : °C Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 17, E'C' lI PERMIT NUMBER 04* * 1 7,00 *17.00 1-6 164.02 1:1 ,-09-81 z 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. B Iding Technician PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED 164,1Z *17,00 - PERMIT NO. TOTAL