1980, 04-14 Permit: 80-3490 Special InspectionPLAN 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
,a0 o/S/t
LOT
BLOCK
SUBDIVISION
3
OWNER
Cc/GF6460 4/1/7 t,
PHONE
ytg--7g w
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S CPPPOR7t.i Vir Pr
act' 5, (00' LV'S G. op 4C
OF Sr 3 cc, c -c: s r,
ta-vzo - (,%312_
ADDRESS
Z -o/ RGSLt.)A)/S
CONTRACTOR
4. ADDRESS
DESIGNER
ZIP
ZG
PHONE
ZI P
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
Cl PLMB.
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
Actual Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
Type Const.
Occupancy Sprinklered
Dyes ❑No ❑ Req'd.
Valuation
Main Floor
Upper Floors
Building Area in Sq. Ft.
Garage Area
Area of Decks
Finished Basement
Storage
Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd_
Not Req'd.
DESCRIBE WORK
C /x7C /,v.s 770
VALUATION SOURCE
OF
9. UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private 0
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 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buil g echnician
X22,7.
SPECIAL CONDITIONS:
f? i�CA)CE
Scc evoE_ int ci? . i`o Tz �1
L L / CAVO/0 ti
(56cleibelveX)cir---
4'f
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
�s/9 L
Other'Specify)c'")
TOTAL $
PERMIT NUMBER
-31-70
02* *800
*800 1-6
340,9-2
04-11-80
G 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE I SUED.
PERFI4IR,d) o * 8 0 oT®TijL