1980, 09-23 Permit: 80B-759 ResidencePLAN NUMBER
1( 9 /z3/
Basic Plan
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
JO DRESS
J,366 /9h' 176S C' r.
LOT
. S"
BLOCK SUBDIVISION
•
OWNER
N c c
ADDRESS
e . )27i SPlsiccf u�
CONTRACTOR
4- ADDRESS
DESIGNER
5' ADDRESS
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S
-yz
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
M NEW ❑ ALT.
BLD. ❑ PLMB.
ZIP
99z,
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N. ❑ RPL. ❑ MVE.
❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
Actual Set Backs in Feet
North /Si 'South Z4°-
East ! eo `.3 i 'West
Size of Parcel
8c.°x
Type Const.
Occupancy
Ahiation
3. 7:o cs
Main Floor I Upper Floors
Zone Cla Lssiifircation
G
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
storage
Area of Decks
Finished Basement
Unfin. Basement
y
No. Baths
1
No. Stories
—
DESCRIBE WORK
VALUATION
033 5-4,c)
P-48#4 4-V Re5 42E/LiCe"
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
No. Rooms
Req'd.
SEWER
s4Pr/c
Ownership ,,.,/
Public ❑ Private L7
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 APPLICAN
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env.7t$alyj � 9/
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building T ch nician �+/�
9i�/w
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
J
Recd.
Not Req'd.
FEES COLLECTED
Single $
Building *2/0.00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ?/b d
PERMIT r.UMBER
e3013- -75q
u2* *210,00
*21 0.00 N
*210.006
A *0,00
464-
09 -18 -80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
o9ki211 0
DATE ISSUED PERMIT NO. TOTAL
75.95 *210.'00' ° -
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