1980, 03-12 Permit: 80-2139 Attach Garage{PLAN NUMBER
e--543
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
• S. 1_►ct 'riiv1W
LOT BLOCK SUBDIVISION
11
3&1rMI4w Ate'
O NER
3 t-A.t., 'AK) A
ADDRESS
54ISIR / ETriviI9-w
CONTRACTOR
SAN
4. ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
NEW
BLD.
❑ ALT.
❑ PLMB.
PHONE
53 7-77
ZIP
9120G
PHONE
ZIP
PHONE
ZIP
TO
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S Z4533—I
4. 07 5 2/, zar3zc7rYhhi9iv A', 14
Required Set Backs in Feet
North r South -`
Size of Parcel
Type Const. Occupancy
V -N a-3 *AI
DESCRIBE WORK
8. A -Tr Ac ucc C AP_ e --4)
VALUATION
9.
Ex/Srivu4 Re , D Gro Cc'
Source
of
Utilities
GAS
ELECTRIC
DWL Area
Basement Area
Split Entry
No. Baths
East J West
Zone Classifica ion
Spfinklered
❑Yes ❑No ❑ Req'd.
76'
Garage Area
Split Level
CERTIFICATE
of EXEMPTION
WATER
Storage
Rancher
No. Rooms
1
SEWER
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 In of a permit does not presume
to give authority to violate or cancel the provisions of any other state or I I la regulating construction or the
performance of construction. ^�
DATE ? O V
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
X Env. Health
Planning
3'ra•2o poNl coo
Fire Marshall
Co. Engineer
SPECIAL CONDITIONS:
140013 rL-isrJ04,1clArNi t3r
Utilities
PLAJ 7-f-rPoiw(�a
MN-, -i2' ciA
GA S ol,j �I k
Zone Clearance
SEPA Che ckffOME OWNER'S WARRANTY
YES I.. i
NO Li
PLANS Al OV 10.f'�
DATE 31241) OFFICIAL/
APPROVED FOR ISSUANCE
Rec. Room
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
5o ,0°
4-4
0
a
PERMIT NUMBER
?o
DATE 3'/ -7d
02* *5000
*5000
*50006
E *000 0
19582
03-10-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'3=12-80
213,95 *5O.002H
S, IS \9 —BE TCw„All.i
Less 1"`µ"'1
zt412-- z.39"
--Pi-acEL- #- 2, 5 3 3 _
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yqne
id.aSt;,1/435
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