HomeMy WebLinkAbout1980, 09-23 Permit: 80B-760 ResidencePLAN NUMBE
Vs
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
N.
LOT
2. 9
/209
BLOCK
,4AT /E5
C7 - .
SUBDIVISION
PHONE
9eZ'-r:/0,5r7
OWNER
/VDc:« C'®/uSTR69CT° /ord
ADDRESS
/Z7 / G. 54t'6
CONTRACTOR
.5/9197C
ADDRESS
S
DESIGNER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
i85si - zizcq
ZIP
PHONE
ADDRESS
6.
CHANGE OF USE FROM
TYPE
7. OF
WORK
I"NEW ❑ ALT.
LIA BLD. ❑ PLMB.
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Actual Set Backs in Feet
North . r 'South 7 d
Size of Parcel
AiMe
Type Const.
Vryluation
"4J 33 :TOG
liEast 1O 4 West I a i
Zone Classification Xis ,5443
>..544seepee - fr
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
86,/
DESCRIBE WORK
8.
VALUATION
.3
O" i C-
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
/C
Main Floor 4/
Area of Decks
Upper Floors
No. Baths
Garage Area
Storage
Finished Basement Unfin. Basement
r
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private
No. Rooms
y
No. of Dwellings
Req'd. Rec'd.
Location (Area)
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 SIGNATURE OF APPLI ANT
SPECIAL APPROVALS
NAME DATE
Env ' -a th
I / 1
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bui Tech /
SPECIAL CONDITIONS:
R.%/V5 OA) F)46-
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
210.00
TOTAL $ 210'0°
PERiviiT NUrviBEk �I
aoa
02* *21000
*21000
*210006
*000 8
465-2
09- 18-80
z 647'9:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
r 9,42 Y- 8 0
DATE ISSUED
6. 0 z *2 1 O
PERMIT NO.' O,TOTAL
At&sz)- 45837- Ve
9
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