1980, 07-02 Permit: 80-6609 Flat to Pitched Roof(PLAN 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
1
JOB ADDRESS ..�� (j
L8; 1' 1' iUBDIVII �N S
2 0"1. I 'l U tJ n' 'TAN% ' 17 /41 D
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
1--P# v /)y=��
ADD ESS
PHONE
IV's 0661
ZIP
PARCEL NUMBER/S
Actual Set Backs in Fee
1South
North
East (Wes
CONTRACTOR
4. ADDRESS
�
P ONE
i
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ZI P
Size of Parcel
Zone Classification
ResiowuriAC. )
c - f
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
ZIP
TO
C
❑ NEW ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. /❑ PLMB. 0 MECH. 0 M.H. 0 POOL
❑ OTHER
Type Const.
Occupancy
Valu BuildingArea
ValuationFt.
3�j8in Sq.
13
Main Floor
Upper Floors Garage Area
Storage
Area of Decks
Finished Basement 1 Unfin. Basement
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
D SCRIBE WORK
VALUA31,0N %OURCE Gyp
OF
UTILITIES
2
/R
CTRIC ,WATER SEWER
CfiYLs�/, �
Enum. Dist. I
Ownership
Public ❑ Private
Req'd. Rec'd.
Location (Area)
USE CODE
I hereby certify that I have read and eamined this aption 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
v SIGNATURE OF APPLICANT
SPECIAL APPRObALS
NAME DATE
Env. Healt:w
Planning
Fire Marshall
Co. Engineer
Utilities
tans Exami
SPECIAL CONDITIONS:
/Vo ,41e- /4C3-14 C {0
�dq s-1. S
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Req'd.
FEES COLLECTED
Single $
Building '46'6.` co
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 6LROC1
PERMIT NUMBER
ec - 66, 0,-
02*
%
02* *6aoo
*6800 67)
*68,006
B *000 0
660,48
07-02-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 $h' -'0'2-t8 0
DATE ISSUED
66'0,92 *68,0.T'
PERMIT NO. TOTAL