HomeMy WebLinkAbout1980, 07-09 Permit: 80-6864 ResidencePLAN 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
JOB ADDRESS
LOT
ij,4. y4R7ES
BLOCK SUBDIVISION
4 w/, 'r.:_ un 43 //9 Ao.o.
OWNER
3. /11411.4 DNS 7/a r+✓
ADDRESS ZIP
Z` zi G 994
CONTRACTOR
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
'&5S-1 '/ o3
4.
ADDRESS
Sdv -ie
DESIGNER
r.
AN
ADDRESS
6.
CHANGE OF USE FROM
TYPE
7, OF
WORK
LJ/ NEW ❑ ALT.
IJ BLD. ❑ PLMB.
Actual Set Backs in Feet
North /61 South 3o •
East
West Z`S
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Size of Parcel
Type Const. I Occupancy
Vlikiation
C33, Sao,
Main Floor I Upper Floors
Zone Classification
e" AnlieSapi
Sprinklered
Des ❑No ❑ Req'd.
Building Area in Sq. Ft.
165%
Garage Area
Storage
Area of Decks
gd
Finished Basement
Unfin. Basement
86,
No. BBaths
No. Stories
Z
No. Rooms
No. of
Dwellings
DESCRIBE WORK
8. S //-Xa Lu- F%901tca/ c-s- '�/ry�e••_ c
,i VALUATION SOURCE GAS ELECTRIC
9. 333, 5� • O
N OF
UTILITIES
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 reg , ating con ru tion or the
performance of construction. EE EVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION `emu SIGNATURE OF APPLICANT - //f)
WATER
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
SEWER
Ownership
Public ❑ Private
Req'd.
USE CODE
SPECIAL APPROVALS
NAME DATE
Env. = It
Planning �/
Fire Marshall
Co ng er 1/L )o
Utilities `/
Plans Examine
SEPA Checklist
BuilQQd''i Tec nician
j 7`7
SPECIAL CONDITIONS:
bu+ l s k t z - cc.A.rb e ( -ve • iptir P\ \-
acvivo„ck
IJ7 c0 w 1 11/ d■ 5
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building AZ /G'
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ CP
{RMI t NUMBER
02* *21000
*2.1000
*210.006
E *0.00 8
675.6
07 -08 =80
61179,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07 ,-,09"-80 68`6,45 *210.002P
DATE ISSUED
PERMIT NO. TOTAL
132.'4 •
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4
A s
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