1980, 01-21 Permit: 80-432 Addition•
PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 911 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1.
LOT BLOCCKUBOIVISIOIV
2.
3 NE�C%�Z
R J(/ i3
ADDRESS
7f . i / a V' ._+,d t"._e 2>'.� _>:L
` AQV{; f�AC OR
4. ADDRESS c3-.y�7
/ */ E may
, -2 J t AC�
DESIGNS
5' ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
y 2 -/.2a9
ZIP
49a.a;
PARCEL NUM BER/S/i/_-� 31-2-1
N N w4 e�7' / to rS� yF /V
A74 ‘6-171z-9/-21
Required Set Backs in Feet
/
North ".cam'South ...2•45-
East27West35
PHONE
9z h��-s,C3
Size of Parcel / I Zone Iassification
/4,,-1— 1X — 1
ZIP
99.2��G
Type Const. Occupancy
Sprinklered
Dyes ❑No D Req'd.
PHONE
ZIP
Valuation
Building Area iy Sq. Ft.
DWLJAre! I Basement Area Garage Area
'745 G
0a
Storage
CHANGE OF USE FROM
6.
TO
Split
Entry�SP ev
Rancher
TYPE
7. OF
WORK
DESC IB WORK
1�/
�J 1 - ELEC9TRI
❑ NEW
❑
BLO.
O ALT.
❑ PLM6.
AD'N.
0 MECH.
D RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
C
ALUATION
FODD�
Source
of
Utilities
GAS
%I/et-44424f
��r/Z/L 7 SEWER
WA ER
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 to al law regulating construction or the
performance of construction.
DATE / /� — ?e/ SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
4,0J
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
/?/?&sA--r.
DATE 1/2 1 OFFICIAL LA -4 -
APPROVED FOR ISSUA
FEES COLLECTED
Single S
Building ir0" Q�
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
,L� a
Jvif
DATE
PERMIT NUMBER
g'o -Lc
02* *10400
* 10400 115
* 104006
E *000 3
43.12
01-21L80
2 6479
- U
a
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
43,22 *1040.02-
- 4