1980, 12-24 Permit: 80B-5228 ResidencePLAN NUMBER
/e- .00.x-
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
3.
JOB ADDRESS
-Al _oat /.
L.T BLOCK UBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
PARCEL NUMBER /S J 5/—
c'r 7 BLK'
PHONE
DRESS
dd!
PPER. C A. A c A A
Actual Set Backs in Feet
Soth �� East North West
CONTRACTOR
4. Saf./y.a/Lil
A DRESS
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
TYPE
7. OF
WORK
NEW
BLD.
❑ ALT.
❑ PLMB.
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Zone Classification A 0
Sprinklered
❑Yes ❑No ❑ Req'd.
luation t56
Building Area in Sq. Ft.
Area of Decks
£tV ONCOv.4Rep
No. Baths
DESCRIBE WORK
0��-
A
.
ALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership
DU OF C Public ❑ Private tit
9.29„ .z6,6 ;- DTILITIES -�'T tIL
1 he reby 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
Garage Area
Storage
Finished Basement Un sement
No. Stories
1
No. Rooms No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Redd. Rec'd.
Location (Area)
USE CODE
DATE OF APPLICATION /.2
(---'j_141/1-.P.
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Fire Marshall
Co. Engineer
Utilities
Bui !ding TTeec nicia
in
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
DO
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /<-3 (d
PEA. "RlT NUMBER
32* *193.00
*19300
*193.006
A *0.00
522,78
12 -24 -80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
121 ''4'- 118 b'
DATE ISSUED
5,2a8Z *193.00'20
PERMIT NO. trJ i A,L
ik