1980, 10-27 Permit: 80B-2744 ResidencePLAN N JMBER
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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
1.
2.
3.
JOB ADDRESS
/8 6o2
CLOT
T
OWNER
BLOCK
Brie—Duc)//i 144/C
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
S /r*i45'4/ 5 /S, 1'O7'T/ofv�
PHONE
PARCEL NUMBER /S
ADDRESS
-.4303 BA- 20.9,2w.411
ZIP
99 zo6
Actual Set Backs in Feet
North 37' South G.
East West 3c
4.
CONTRACTOR
A/5/ c l7i7P, /1/
PHONE
9Z6 -9'Z /7
Size of Parcel
/ /e3
Zone Classification
ildPt d uR& '
ADDRESS
° 0 3 .;rGiflJiihf
DESIGNER
5. ADDRESS
ZIP
PHONE
ZIP
Type Const.
V-- 1\%
Occupancy
' T
Sprinklered
❑Yes ❑No ❑ Req'd.
Va dition
Main Floor Upper Floors
/3yv
Building Area in Sq. Ft.
/67_
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finishe
d Basement
Unfin. Basement
1.3-/4/
TYPE
7. OF
WORK
,L.7�J,/NEW ❑ ALT.
LJ BLD. ❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
a
No. Stories
CERTIFICATE
of EXEMPTION
DESCRIBE WORK
8. 5 /If6'," A740214 `/ ;I''CS /glc`:-/vC
VALUATION
5-YeyQ
SOURCE
OF
UTILITIES
GAS
Enum. Dist.
No. Rooms
No. of Dwellings
1 Location (Area)
Req'd.
Rec'd.
Not Req'd.
ELECTRIC
WATER
SEWER
Ownership ,,Cc,,
Public ❑ Private/1'6
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 INSPECTION
DATE OF APPLICATION
,C)aT g 0
SIGNATURE OF LICA
SPECIAL APPROVALS
NAME DATE
Env.J4ealth
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
`i M Pa s-tc%.WM-r
SEPA Checklist
Buildin echnicia
e/
SPECIAL CONDITIONS:
re 6-
0
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building It :248 ' QCs
Plumbing -
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ %b►
PERMIT NUMBER
60 F
02* *29800
* 298.00
* 298006
A *000
274,32
10 -27 -80
O. 6:479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
O nl? +7 -1 81
274, 42 *,298,0.0°,
DATE ISSUED PERMIT NO. + OTAL
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