1980, 12-11 Permit: 80B-4793 InsertPLAN 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.
LOT
2.
BLOCK
LEGAL DESCRIPTION — SEE ATTACHED
SUBDI'/1S 10
PARCEL NUMBER/S
4.
OWWN R
ADDRESS
_ej, S706— tua_454_, 461,
COMTRACTOR
44,vK r
AD RESS
DESIGNER
5.
PHONE
ZIP
PHONE
ZIP
PHONE
Actual Set Backs in Feet
North 'South
Size of Parcel
Type Const.
Occupancy
Valuation
East (West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ NEW
❑ BLD.
❑ ALT.
O PLMB.
❑ AD'N.
g MECH.
O RPL.
O M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
ESCRIBE W RK
8. Z .e./I.t-
VALUATION
9.
SOURCE
OF
UTILITIES
AS
ELECTRIC
LavrAtkict
WATER
Enum, Dist. I Location (Area)
SEWER
Ownership
Public ❑ Private ❑
USE CODE
1 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 INSPECTI.NS
DATE OF APPLICATION /a--11 "RG, SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu ding Tech cian
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
fd
Mech. 7 4
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7
PERMIT NUMBER
04* *7.00
*7,00
*7.008
*000 8
479.22
12-11-80
z 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.12,4.11=8
DATE ISSUED PERMIT NO. TOTAL
479.32 *7..004f.