1980, 06-20 Permit: M80-6051 DamperPLAN 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 3 COPIES
JOB ADDRESS
LOT
BLOCK
4' ADD RESS
SUBDIVISION—
0
0 E2 4:41
ADD RESS
/31 /L / Le,i'
CONTRACTOR
t?2 / –t'2s
DESI GNER
J. ADD RESS
ZI P
PHONE
_ZIP
CHANGE OF USE FROM
6.
TYPE
7. OF
WO R K
PHONE
ZIP
TO
❑ NEW ❑ ALT. ❑ AD N. ❑ RPL. ❑ MVE.
❑ BLD. ❑ PLMB. XMECH. ❑ M.H. ❑ POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
Actual Set Backs in Feet
North South East 'West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑NO ❑ Req'd.
Valuation
Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area
Storage
Area of Decks
No. Baths
DE RIBE WORK
8. 4 n . a -x„
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
SEWER
Finished Basement Unfin. Basement
No. Stories
No. Rooms
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private ❑
Req'd.
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
SPECIAL APPROVALS
NAME DATE
SIGNATURE OF APPLICA
Env. Health
Planning
Fire Mars hall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /
-ft
PERMIT NUMBER
04* *7.00
*7.00
*7.006
B *0,00 8
60508
06 -20 -80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,'
THIS BECOMES A PERMIT.
0'6- 20-8:0 605.12 *7,0:0° —
DATE ISSUED PERMIT NO. TOTAL