1980, 10-17 Permit: 80B-1902 ResidencePLAN NUMBER
R- 7
B
Plan
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
. AP:,ICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. ,%Rc er7
LOT
2. Al
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK SUBDIVISION
/
1"7-.00ti4 440 7,0A/
PARCEL NUMBER /S .. �_
OWNER
3 60•V STaucreori/
ADDRESS
/27' C7c16
PHONE
92e-- lio9?
ZIP
Actual Set Backs in Feet
North 4/51 South O
East 1;,3 'West
CONTRACTOR
ACID R ESS
PHONE
Size of Parcel
/4W. !rte X /o
Zone Classification
ZI P
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
ogev- cam
Building Area in Sq. Ft.
got-)
ZI P
�M,yain Floor I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
,�,eNEW ❑ ALT.
/
L"J BLD. ❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
/
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Y
DESCRIBE WORK
8.. //1iEai E
%?/ /!aE71...c e"
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Sr, C
Enum. Dist. I Location (Area)
1
Ownership ei, USE CODE
Public ❑ Private
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_.�.0 io `' SIGNATURE OF APPLIC
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
cAV
, ca i/ 'Pew. °It ea ,3- /gcra
L SC G rhr.44He-4D)
cif
4ffieve0
CdFfit_ ncviu 5 "77,447,6-
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building ?J/ 00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ZIr•o6
rPERMIT NUMBER
No i eES
C ..c.. c`reo
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
PERMIT NO. TOTAL