1980, 07-23 Permit: 80-7550 ResidencePLAN NUMBFF?
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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 ADD RfS /2/ W7 /CSC
2.
Ibs�
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T BLOCK SUBDIVISION
OWNER
3. .. -
A DRESS
1
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
CONTR
CTOR
ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
ESt. NEW
❑ BLD.
❑ ALT.
❑ PLMB.
ZIP JJ
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PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
PARCEL NUMBER /S
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f. PPE R (3c)L /JM/3JA ADO
Actual Set ! Blacks in Feet
North South East 4".
Size of Parcel
West /.'J
Zope Classification
PERMIT NUMBE
8o S:5o
02* *21900
*21900'
*219006
E *000 8
Type -onst. •ccupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
Main Floor
2•'
Upper Floors
Area of Decks
Building Area in Sq. Ft.
Garage Area
Finished Basement
At
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATE R
SEWER
No. Baths
J
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
Req'd.
Location (Area)
Ownership
Public ❑ Private ',Q
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 —I ri SIGNATURE OF APPLICANT
SPECIAL APPROVALS
h NAME DATE
En eal a 7/2'
Planning Z'
Fire Marshall
Co. Engineer
Utilities
Plans Examiner 1
G �1�1 Po S'(1 F.c)hf -172
S PA Checklist
Bu ding Te nicia
/
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Storage
Unfin. Basement
No. of Dwellings
Rec'd. Not Req'd.
A
FEES COLLECTED
Single $
a
Building Z // G
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
G
07 -21 -80
L" 2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,0' 7 -►7 5 L 8 0
DATE ,SUED
75532 le219.002.-
PERMIT NO. TOTAL
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