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1980, 09-09 Permit: 80-9859 ResidencePLAN 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 .gDDRESS 1. IS( r 12I LOT 2 I' owr�� 3. AO__ BLOCK l7• SUED VI ION 4-I IGNI ►� ; t\J leo o I. f5>4.9( 1 -96\K ESS I. -2I I I� RHONE —7a2 LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S Ip 5+I ., 0-7I Actual Set Backs in Feet North (South East (West CONTRACTOR 4' ADDRESS PHONE ZIP Size of Parcel liCA212o Type Const. Zone lassiflcation Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. ADDRESS ZIP Main Floor Upper Floors 1 Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK ❑ NEW ❑ BLD. ❑ ALT. O PLMB. ❑ AD'N. O MECH. ❑ RPL. ❑ M.H. ❑ MVE. 0 POOL 0 OTHER No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK 8 I2 VALUATION 9. (\/� I� J o1�•1f L -�-`� I I SOURCE GRS ELECTRIC WATER SEWER OF UTILITIES Enum. Dist. Location (Area) Ownership Public 0 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 lo w regulating construc .r the performance of construction. SEE REVERSE SIDE FOR REQUIRED (NSP I)NS DATE OF APPLICATION SIGNATURE OF AJ SPECIAL APPROVALS NAME DATE Env. Health Planning . Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist SPECIAL CONDITIONS: k6f,m4ock. "r- o� II or 5l 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 $ PERM( f NUMt3`ER cc-) •9857 02* *12.00 *1200 ro 98582 09-09-80 2 6.479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 019, 0V-81`01 DATE ISSUED 985,9`x, PERMIT NO. TOTAL