1981, 11-30 Permit 81B-1859 Cert of OccupancyIl•AII••AU.•ldN. NIN • • VVAAMW • ► MINWPiiNANMPAMMM.CIMINNMWMPAMPANN NAMIAMPAMWMMONNAMWMIAMPAlu
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K.11-3.0-81
81B-.1859
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Date BU I LD I N G C 0 D ES D EPA RTM EN T Permit Number
4
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Certi• ficate of Occupancy.1
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Building Address: East 12508 - 4th Avenue
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22542-1420
Lot: Parcel No. # Block Addition:
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Owner. Robert B. DaJe Address: ...Fst.12508,-.,4 th, Avenue
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Occupancy Group:... R—.3/E-3 Land Use Zone:
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Construction Type of Building: u—Il. Occupied as: . Day. . Care. ./.. Res.i.dence
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Occupant Load:
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Additional Information: ............
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Permit reaui red if mod . stove . should. be..i.ns.tal.l.ed!
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This Certificate is issued pursuant to Section 307 of the Uniform Building Code and is to indicate the above
described structure is approved
for occupancy.•
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Fire Prevention Inspector Building Official's Signature
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THIS CERTIFICATE MUST BE PERMANENTLY MAINTAINED IN ALL BUILDINGS OR STRUCTURES REFERRED TO ABOVE -If the building or structure
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is used for any other occupancy than that listed, an application for change of occupancy shall first be made to the Building Codes Department of Spokane
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County.
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PLAN NUMBER
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
JOB ADDRESS
E. 1 5
LOT BLOCK
2.
OWNER
3.
ADDRESS
, I.508
CONTRACTOR
4. ADDRESS
�VtiUI V ICI UIV
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
❑Yes El No ❑ Req'd.
Valuation Building Area in Sq. Ft.
Main Floor
Upper Floors
Garage Area
Storage
Area of Decks Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
DESCRIBE WORK
8. S7EGi.Y i'u c—rioi - CQ T11=1C:/Vi'6 do CLrGt./'0ANG„-j
i
VALUATION
9.
SOURCE GAS ELECTRIC
OF
UTILITIES
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public 0 Private 0
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 jJ /v// V
SIGNATURE OF APPLICANT•
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS: cl0 Fop.,
4'/' / ;Pt- : F• r �!'c^ �L%OQ 74;;*
r9h SG /
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/./s4 / � S ?`G!/� /47 s J. - e 'I �P/►� G'
rf'er‘.7iit
s7(4',//e /7rA7m 7 Ar/y/ e
.-� r / s "' /Ac/ 5 4, fie,
PERMIT IS NONTRANSFERABLE
A -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
—Mech.
Plan Check
SEPA
• l4obile Home,
!Other (Specify) •O0
TOTAL $ CR, •.00R
02* *8.00
*800
185.82
11-16-81
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1
.1 716 - 8.1
DATE ISSUED
18:5.95 *8.00;�
PERMIT NO. TOTAL