1980, 10-30 Permit: 80B-2932 ResidencePLAN NUMBER
/Z -2448
,o,/ ,Q /ed
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
BLOCK (SUBDIVISION
i *.
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3. 44 i,v
ADDRESS
sa-
PHONE
qZ6 - 92,/ 7
PARCEL NUMBER /S
13 - 5.24'
4:45c,Na .afreo sap 4004y
CONTRACTOR
4
N.. ; /s7I ' os ti -5l2 .
' ADDRESS
C= - 95th
DESIGNER
5. ADDRESS
ZIP
eqqZ.0 6
Actual Set Backs in Feet
37 'South %SLS East /Si 'West /0�
North
PHONE
Gi a -9 7
Z P fJ
Size of Parcel
s it-
Type `Copns /t.
Occupancy
Zone Classification
Aekei. 54r,3 ifRA,4 /r''
PHONE
ZIP
Valu on
52 % %f
Main Floor
/ _ e,0
Sprinklered
❑Yes ONo ❑ Req'd.
Building Area in Sq. Ft.
/896.
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
/0,->o
TYPE
7. OF
WORK
L NEW
,►,J/
ICJ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
1
CERTIFICATE
of EXEMPTION
No. Rooms
5
Req'd.
No. of Dwellings
Rec'd.
Not Req'd.
DESCRIBE WORK
8..SiAca` 69
l/ALUATION SOURCE
OF
9. .�• , .4/ UTILITIES
GAS
ELECTRIC
WATER SEWER
-Se-op c
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private t#
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 APPLICATION2. --45 tie-, SIGNATURE OF ,KPPLICA
SPECIAL APPROVALS
NAME DATE
eal
PI
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
"Y3o190
TOM PoS?L 41
SEPA Checklist
BuildLechnician
SPECIAL CONDITIONS:
K e.t.>S o.* >2 ;; 9-
0
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ aqZ f&C)
PERMIT NUMBER
02* *29200
* 29200 tz
* 292006
A *000
2745
10 -27 -80
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10,115v 0,.
DATE ISSUED
295.22 *2920.0x0
PERMIT NO. TOTAL
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