1980, 09-30 Permit: 80B-1121 ResidencePLAN NUMBER
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
JOB ADDRESS
1 LQTZOC SgIDN J 61-4'1ir�� —t ''
2. /
OWNER PHONE
AD RESS ZIP
C+ T ,z / ,off �.c.Q l i,� e 99Z./
CO TRACTOR PHONE
4. �' 44/1/1 /
�DRESS�
/L'VLL>
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WO RK
NEW
❑ BLD.
DESCRIBE W•RK
VALUATI
❑ ALT.
❑ PLMB.
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S /67;„75--.0
rr c�,��
0PP,cie P' 2Liiy 13i A A bD /r/ N
Actual Set Backs in Feet
North !South
Size of Parcel 1
Type onst. ccupancy
V uation
3� J �-i dd
86 if
Main FIoo/ Upper Floors
Area of Decks Finished Basement Unfin. Ba
East (West
Zone Classificati
C44/144,cu, J
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in 5q. Ft.
Garage Area
Stor rage
No. Baths
I
No. Stories
ti
dQ
J
SOURCE
OF
UTILITIES
GA1
ELECTRIC
WATER
SEWER
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
171.
Req'd.
Location (Area)
Ownership
Public ❑ Private pg
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 q -02. J —ff SIGNATURE OF APPLICA
SPECIAL APPROVALS
NAME DATE
En e th
r���__ 7,4
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Byijding4 nicia
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
ment
No. of Dwellings
Rec'd.
Not Req'd.
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PERMIT NUMBER
8cUi3 -\2(
02* *21000
,210,00
*21 0,006
is
*000 8
91,7g.
0'9 -26 -80
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09- 13'0-80
DATE ISSUED
11215 210:002 -
PERMIT NO.
TOTAL
Ett,t)0:1sevt..)
—rotck.s..„
000
.0
otit.4
ww.....wroNsr
LL 0,4) utyleN