1980, 09-26 Permit: 80B-949 Repair Fire DamagePLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
6. eg o c' /9c is /
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
OWNER
Fdi/"V
ADDRESS
PHONE
1/ %
PARCEL NUMBER /S .� L`x " ,e,
/341K lei /i rCH/.vSo/t.5 PJ.
/g..5.749- o3 S/
ZI P
erei tee
Actual Set Backs in Feet
North 'South [East (West
4.
5.
CONTRACTOR
773/J4 / Ccfi57/?
re'c ot,) /f✓ C
PHONE
6-31 -ev-
Size of Parcel
Zone Classification
146 . a yr3 u,(,,?.
ADDRESS
EM z7/8 SPe2,1tc a&
DESIGNER
ZIP
4719e 4)-z
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
ADDRESS
ZI P
V a l u Cn] C
Main Froo
ii 90
Building Area in Sq. Ft.
/1' 0
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8. Rd-P/9
ALUATION
•9, 500
';,e .t7.a .4 d-
CERTIFICATE
of EXEMPTION
Enum. Dist, Location (Area)
Req'd.
Rec'd.
Not ,eq'd.
SOURCE
OF
UTILITIES
GAS 11 ELECTRIC
WATE R
SEWER
Ownership
Public ❑ Private id
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 7- 2 cO C
SIGNATURE OF APPLICANT:
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B�Technician
SPECIAL CONDITIONS:
/2eP "ece i3/z y v✓itr .���rY i ,erc eat Ili. TC /f��v
E 6 Z4fr-rc s
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ FV:)-
PERMIT NUMBER
.63.0- cT
02* *8000
*8000
*80,006
R *000
9482
09 -26 -80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 9'2 6 " -8'0
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
9492
PERMIT NO.
*,80.0.0°1
TOTAL