1980, 10-30 Permit: 80B-2933 Residence(PLAN NUJMMBER mg
APPLICATION /PERMIT
r e /?e0c) SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
1.
2.
3.
JOB ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
)17 Vier
LEGAL DESCRIPTION - SEE ATTACHED
LOT
OWNER
Az '4,v B . nafQ.S r•�
BLOCK SUBDIVISION
,4Oi 'ire, esi
PHONE
q C"eAzi t
PARCEL NUMBER /S
ADDRESS
. 4..30s
4.
CONTRACTOR
z( >�i4CNUAt -'
ZIP
Actual Set Backs in Feet
North 37' (South
East /1 • 'West /C)
PHONE
9r-4 Zi
Size of Parcel
Zone Classification
4t5e /. -5 /eI.' 63r i1,/
ADDRESS
6 9303 a2 c tio&,4 ,
ZIP
'17q10;6
Type Const.
V ri
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Val ion
z dC)
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
0:39C/
Upper Floors
v
Garage Area
S
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
/car' (7
TYPE
7. OF
WORK
�A NEW
LJ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
f
No. Rooms
No. of Dwellings
f
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not,Req'd.
DESCRIBE WORK
8. ,5'i- c.
ly VALUATION
/fir,
SOURCE
OF
UTILITIES
. ,j,e &,vice 4. iI‘s6 ,t p. .0.
SEWER
ce -401rC
GAS
ELECTRIC
WATER
Enum. Dist.
Location (Area)
Ownership
Public ❑ Private ❑
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 o r the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPEC NS
r) SIGNATURE OF • ' • LICAN
DATE OF APPLICATIO1V�
SPECIAL APPROVALS
NAME DATE
Envea
Planning
Fire Marshall
Co. Engineer
Utilities
/04/
Plans Examiner
Tom Posm MJMT C'01
SEPA Checklist
Bui din echnician
C' ldf2
SPECIAL CONDITIONS:
FEES COLLECTED
Single
Building
Plumbing
/C ,& E
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
$
#2g8.ao
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 2V•Q
PERMIT NUMBER
02* *298,00
* 29800
* 298.006
A *0,00 8
274,62
10 -27 -80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10”ftiii.80 '
DATE ISSUED PERMIT NO.
29'13 *296.0 -0a °i
TOT,A
I,
42 0 1.4.(1. t (I/ 'Kt4 a!
98.52
>: r� CA!.
- k K.1. VU(2
P rJ: ASS 21-a
95, *2'
so