1981, 07-14 Permit 81A-6958 Hay ShedNUMBED 2 _ APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
JNORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
" APPLICANT: COMPLETE NUMBERED SPACES -
PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BL CK
SUBDIVISION
PARCEL NUMBER/S
. I
1.)rI
2.
l
OW
P ON
3.
ADDR S I I
{L!�
IP
Actual Set Backs in Feet
0 e
�'/"
North South
East
West
CONTRACTOR
PHO E n
Size of Parcel .� Zo e ssification
4. 5I
P
Typ9�onst. O
!
SprinkleredA
oZ
❑Yes ❑N❑ Req'd.
DESIGNER
PHONE
Valuate
Building Area in Sq. Ft.
?,
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
LStorage
V
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
1
L—
—
—
TYPE ❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
No. Baths No.
Stories
No. Rooms
No. of Dwellings
%
El OTHER
(�/f�1'��W
WORK '—' BLD. ❑ PLMB. ❑ MECH. ❑ M.H.
El
CERTIFICATE
Req'd.
I Rec'd.
Not R cl.
of EXEMPTION
D55C RI Ei E WOR
8 `/
✓�n
[ice _q
-
•�
Enum. Dist. Location
(Area)
FEES COLLECTED
VALU
ION
SOURCE
GAS
EL CTRIC
WATER
SEWER
Ownership
SE CODE
OF
Q, UTILITIES Public ❑Private Single $
1 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 Building
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 I Plumbing
PERMIT h.° IBF-
02, *44.00
*44,00
*44.00�
A *0.00
694,52
07-13-8�1
z 6479.
DATE OF APPLICATION -4 SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CIONDITIONS:
NAME DATE LVI j� ��fj jj r Plan Check
T� J/j
2 / I SEPA
Planning C
C
Fire Marshall Mobile Home
i
i,
Co. Engineer Other (Specify)
Utilities
TOTAL $
ns a i er
WHEN MACHINE VALIDATED IN THIS SPACE,
SEP� Checklist THIS BECOMES A PERMIT.
'!� b95,8z, *4400
Buildi �cian d PERMIT IS NONTRANSFERABLE ��g� 1 4,: 8 1 —
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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1\100
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