1980, 09-30 Permit: 80B-1120 ResidencePLAN NUMBER
g - '74- 41/3a1 ez'
Basic Plan L/
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
71 /<3d
LO
2. /
OWNER
3.
BLOCK SUBDIVISION
j
.4 –4._
ADDRESS
6 1, 7r42-1-atea. �
CC// "
O TRACTOR
4. '2vl1y
AC.33RESS
4441
DESIGNER
5' ADDRESS
PHONE
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S / ?6-.6 j,
U P/-'.Et? (2• OM 13 /A ADDi77d11/
Actual Set Backs in Feet
North 'South [East (West
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
NEW
❑ BLD.
D SCRIBE WORK
• . di
❑ ALT.
❑ PLMB.
PHONE
ZIP
PHONE
ZIP
Size of P9rcel
k X Z //
Type Const. I Occupancy
V luation
442
33/oDv
Main Itloof I Upper Floors
TO
Area of Decks
Zone Classification p
ZLI
r T L J Sprinklered
Dyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
El AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Storage
Unfin. Basement
n'4/
No. Rooms No. of Dwellings
Req'd. Rec'd.
VALUAT Oki
ve 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
.L iJI ...
SOURCE
OF
UTILITIES
AS
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private L1Z1
USE CODE
DATE OF APPLICATION C% ---as —a d SIGNATURE OF APPLICAN
SPECIAL APPROVALS
.P.AME DATE
Env. 7 al
PI.nning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu ing ech{tician
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
�/4) �,
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
QO
TOTAL $
PERMIT NUMBEr2
801 -Itzu
02*
*2_,1000
*21000 tri
*210006
*000
91.92
0.9 -26 -80
r 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 9'' 40310'` 0 0
112,02 *210.002F -
DATE ISSUED PERMIT NO. TOTAL
lec)/ o.,71
cyrA./
rSs-s► - <i'ta
211 j
otter A
1 C:)__1./a)