1980, 03-06 Permit: 80-1830 Special Inspection - FoundationPLAN 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 4 COPIES
JOB ADDRESS
� .wL)
3
LOT
OWNER
ADDRESS
SUBDIVISION
CONTRACTOR
. L A. e-
ADDRESS
DESIGNER
ADDRESS
PHONE
ZI P
ZIP
9�2a"
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Required Set Backs in Feet
North South
Size of Parcel
Type Const.
Valuation
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
CHANGE OF USE FROM
6.
ZIP
DWL Area
TO
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
DESCRIBE WORK
VA UATION
9.
Source
of
Utilities
❑ RPL. ❑ MVE.
❑ M H. 0 POOL
44.
G,4S
OTHER
ELECT I
Split Entry
No. Baths
Garage Area
Split Level
CERTIFICATE
of EXEMPTION
WATER
Req'd.
SEWER
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 cal law r-.ulating construct' n or the
performance of construction.
DATE "S— SIGNATURE
DEPT.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
SPECIAL APPROVALS
REQ'D. REC'D.
Zone Clearance
SEPA Checklist
s.miE OWNER'S WARRANTY
L.
NO 1__1
SPECIAL CONDITIONS:
4144/42.4.eZ j/JX,T1-4-7f-1 ///2441A4—
dL4t . (A) 4
DATE
OFF ICIALAt4'W 1,44. "(/
APPROVED FOR ISSUANCE
Storage
Rancher
Rec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single
I N<5P
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
QG
TOTAL fig
PERMIT NUMBER
DATE -3-
02*
* aoo
* aoo
1 80,1
03 -05 -80
6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
03'-10 6-1'0 183 0 z
*8,000
A
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
Gad
¥ I, r
cc