1980, 07-09 Permit: 80-6865 Residence(PLAN 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
1.
2.
3.
4.
JOB ADDRESS
/Z >y /errs
LEGAL DESCRIPTION — SEE ATTACHED
LOT
7
BLOCK
SUBDIVISION
4493€ axe-4,77e in yore,rrmc'
OWNER
WOcc
ADDRESS
6. /e72/
CONTRACTOR
ADDRESS
DESIGNER
5. ADDRESS
C.vsys ; 2crc:;ota`t.,
PHONE
y--
PARCEL NUMBER /S
— 4i2.4:27
Actual Set Backs in Feet
North (10 'South /5
East 2 z% (west /SL
PHONE
Size of Parcel
/ A R 3 / Z .
ZIP
'r Type Const. Occupancy
Zone Classification /4.7
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
ZIP
Va ation
CHANGE OF USE FROM
6.
TO
Main Floor
86
Area of Decks
Building Area in Sq. Ft.
ci
Upper Floors
Garage Area
Storage
Finished Basement
Unfin. Basement
864
7.
TYPE
OF
WORK
If, /NEW
L7BLD.
❑ ALT.
❑ 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.
DESCRIBE WORK
8. -51"LIG
VALUATION
.�
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 regu : ting constr ct on or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SOURCE
OF
UTILITIES
Enum. Dist. I Location (Area)
GAS
ELECTRIC
WATER
SEWER
Ownership /
Public ❑ Private C1
USE CODE
DATE OF APPLICATION
ey)
SPECIAL APPROVALS
NAME DATE
nv�lt
�a 7/9
Planning
Fire Marshall
Plans Examiner
SEPA Checklist
Bui din Tech ician
s-�- 7/7/c'0
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
A/J S tT#ti f /c.6
eu.Adir akci6tCn Curb I C U ). Vcbn"
4gppro'Ch r"`l1
CC#J,O fl10 J5
PERMIT IS NONTRANSFERABLE
0,4- erf=
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building SZ' /0'�
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7/0.
r PErtMIT ;5:.::JIBF.R
02* *21000
*210.00
*210006
E *0.00
675.52
07 -08 -80
Z
647.17%,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Oit0�9�-'80 686,53 '21.0,0021
DATE ISSUED
PERMIT NO. TOTAL
0.
C?
w
U-
el'eat
1,31L
4
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elvt
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