1980, 03-19 Permit: 80-2372 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 4 COPIES
JOB ADDRESS
, / 73/.22 -
LOT LOCK SUBDIVISION
3.
PHONE
9 - /�9
LEGAL DESCRIPTION - SEE ATTACHED
PORT /iA/ oA”
PARCEL NUMBER /S 70-4 -3 - /SW /- /F /a -
LeT 3 ,C3i -K / OA .c iv/ Al Aar? ,6-3
ADDRESS ZIP
e / 79d 9 �+,� 99d/&*
CONTRACTOR PHONE
.3.2 Size of Parcel / Zone Classification
4. Cam_ mat 7 - �U / %U D X �� 11 (44—(∎f aGf�-e -_,
ADDRESS ZIP Type Const. Occupancy Sprinklered
r�A -F
3.2..e) /7 � , - CL X1 /11/4 “i q..2 -0 -- ❑Yes No ❑ Req'd.
DESIGNER
PHONE
Required Set Backs in Feet
e l
North so
South // IEast oC q, 3 West J
5. ADDRESS
Valuation d
�Saod
DWL Area Basement Arya
/66a/ / / /30
ZIP
Building Area in Sg. Ft.
Garage Area Storage
St"
U —
CHANGE OF USE FROM
TO
Split Entry
Split Level
Ranche
TYPE
7. OF
WORK
® NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
El OTHER
No. Baths
No. Floors
No. Rooms
6
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
pESCRIBE WORK
� VALUATION_a
9.
%76,a4
i2ita-chel
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
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 �cpnstru,tion or the
performance of construction.
DATE s.1 —�/� SIGNATU
DEPT.
Env. Health
Planning
Fire Marshall /�
Co. Engineer ,((
Utilities ��VV
SPECIAL APPROVALS SPECIAL CONDITIONS:
REQ'D. REC'D.
241/11 -v 3/�/�
Zone Clearance
SEPA Checklist
i>iOME OWNER'S WARRANTY
PLANS Jt'rR.a1lfo
VES (l DATE 3"18-1"4" OFFICIAL �C-
NO
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $ p
Building �0
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
U
TOTAL $ 3 -2F
DATE
PERMIT NUMBER
So- 2 372.
02* *32800
*32800 N
*328006
E *Q00 °
237.12
03 -14 -80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS 04)- ie9sa,.8MIT.
�0 237,25 328.00°
DATE REMARKS
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
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