1980, 10-15 Permit: 80B-2072 Pole BuildingPLAN NUMBER
0.y
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
1.
2.
3.
4.
JOB ADDRESS
6 • f39/-3 eecoAie
LEGAL DESCRIPTION — SEE ATTACHED
5.
BLOCK
LOT
1
OWNER
ADDRESS
6. /39/3
CONTRACTOR
ADDRESS
/1 / vti�
DESIGNER
SUBDIVISION
r N /WO/Tic tJr/ 7 , Pe";*04/94= btr5
PHONE
Qv-28t� a
PARCEL NUMBER/S
ZIP
Zacetfc-
Actual Set Backs in Feet
North S 'South ICS/ East 3 'West
Gobi..) 72V
T/94,1rt«
PHONE
53s-- 40/
Size of Parcel
4'o X /36
Zone Classification
AO. - r,6tif?,43✓9,L)
ZI��P
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Val tion
Z,36r!
Building Area in Sq. Ft.
.S74 -
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
5-76
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
IJ NEW
itl/BLD.
❑ ALT. ❑ AD'N. ❑ RPL.
❑ PLMB. ❑ MECH. D M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
/
No. Rooms
1
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. ,(- i /9Cf> 00
VALUATION
9P2, 30
%Pe
Enum. Dist. l Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership �/
Public ❑ Private If7
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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
/0-7— 6 2 SIGNATURE OF APPLICANT
R Q
SPEC1; .L APPROVALS I SPECIAL CONDITIONS:
NAME DATE � y�-�
EnvZ9p
alth -
...�, �.-e. It - at. –✓1..�61,
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildin 6
C
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 3,feA0
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$3gt
PriRMI T NUMBER
1-
02* *3E00
* 3E00
* 3 E 0 0'6
A *000
159,82
10-07'-80
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1.0 d.19! 8O
DATE ISSUED
PERMIT NO.' z° * 3'8'
O .r
ALE
-
t
-
PROPOSE D
3ut&p/45
/0/