1981, 03-02 Permit 81A-1941 Relocate Bldg on new BasementPLAN NUMBER
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AI''I''LI ,M I Mini rGnnu■ u
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
OVA I
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1.
LOT SUBDIVISION
2.
3
BLOCK
I(t°
4.
OWNER
--1OJtV7
ADDRESS
CO NT 19R�
N
ADDRESS
6 , PrC1oFm
ZIP
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S, �? 9.- 41--; Or.
i3O'r- 4 r\10- 15 or 1 i v
Actual Set Backs in Feet
North -* South
Size of Parcel
5o x I1-2.T
Types Const.
Occupancy
East 5
1 !�
'West 7
Zo%e eCC,lassification
DESIGNER
PHONE
V4luation
5' ADDRESS
ZIP
Main FI
MDV1i
r
Upper Floors
Sprinklered
Dyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Storage
Garage Area
6.
CHANGE OF USE FROM
TO
Area of Decks
Finished
Basement
Unfin. Basement
TYPE
7. OF
WORK
0/NEW ❑ ALT.
iBLD. ❑ PLMB.
❑ AD'N.
D MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
DESCRIBE WORK ) 1
I . I ice_
SEWER'
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
N1
N1M.
Enum. Dist.
Ownership
Public El Private
Req'd.
ILocation (Area)
USE CODE
Rec'd.
Not Req'd.
iS.
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 f�
SIGNATURE OF APPLICANT t
DATE OF APPLICATION. S/
SPECIAL APPROVALS
NAME DATE
Env./F al h
iJtr_I
ire M rshall
Co
. ngineer
Utilities
Plans
Examiner
a.tr Cry'
S PA Checklist
'Idin nician
SPECIAL CONDITIONS:
I' 7Aq. 1 r I) L- or- ,0—
Nov (Aw, ig& o Ti � link k c e li1
(!ze,e_.0.4.1,14_,tazudy
(4) Krootigor ISINR3N>RA S EFN RBA LE)
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE!
FEES COLLECTED
�
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
02* *10600
*10600 N
*106008
A *0.00
194'02
03-02-81
6.479
5(, 00 7 EE512-41e c79/4
Other (Specify
tCt”
TOTAL
1,
ice
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
8'1 1941 z *10.6_9 0-J
PERMIT NO.
3
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