1980, 06-26 Permit: 80-6377 DemolitionPLAN 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
1. /G. //'Q
LOT BLOCK
2.
OWNER
3.
4.
5.
des.6
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
P617 ?ANi- iN
PHONE
9 -7t;J
PARCEL NUMBER/5 !TU 7-C.,44 Zti.Sa!'{I /f SOD C...2 -
BL
/fir/, -096/
ADDRESS
N//OSS 2ESS/E
CONTRACTOR
SA 4 -x -
ZIP
4Q =CIC
Actual Set Backs in Feet
North 'South East 'West
PHONE
Size of Parcel 1 Zone Classification
ADDRESS
DESIGNER
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation (Building Area In Sq. Ft.
600
ADDRESS
ZIP
Main Floor
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N,
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. Zemcv— iory dF
OF
9. UTILITIES
VALUATION SOURCE
GAS 1 ELECTRIC
WATER
SEWER
Enum, Dist.
Ownership
Public ❑ Private ❑
Location (Area)
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 regulatingnstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION 'S _ go SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
BiAl Technician
f -9---a f/80
P('
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other ISpecifydi
TOTAL $ /Cho d
PERMIT NUMBER
02*
* 10.00
* 10.00 1,5
637.62
06-26-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
b1��2'6-80
DATE ISSUED
637.7= *10.0021 -
PERMIT NO. TOTAL