1980, 06-26 Permit: 80-6350 Residence(PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
LOT
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1/.3e 1 guc/re ye
LEGAL DESCRIPTION — SEE ATTACHED
2. y
BLOCK
SUBDIVISION
191✓n_ Aceas ZepeArir *3
OWNER
3 /0495'cc) C�cP/c i7 �s
ADDRESS
I.36/u ,iy,A/ve0Vie74)
PHONE
7V? -78.416
PARCEL NUMBER/S
(1954/2-/565/
ZI P
99 el
Actual Set Backs in Feet
North 3 'South 3J [East /4; 1West 3c)
4.
CONTRACTOR
Soetinc
PHONE
Size of Parcel
Zone Classification
-S,-.r✓e', 4r f/7/r»c y
ADDRESS
cci4
DESIGNER
5. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
ZIP
luation
3L,cAo
MaintFloor
93z
Building Area in Sq. Ft.
9 3'2
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
Er NEW LI ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
1
No. Stories
Z
No. Rooms
y
No. of Dwellings
/
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
Ff/%?, / ReSiDroldce
VALUATION SOURCE
.OF
0
UTILITIES
GAS
Enum, Dist.
ILocation (Area)
ELECTRIC
WATER
SEWER
/ 7i
Ownership 64,1 USE CODE
Public ❑ Private
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 6 -26 - SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
egth
_eyz G' e
canning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Buildiria Technician
‘a Cr/e/Sc
SPECIAL CONDITIONS:
6/tw5 oev Frcc
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 11 z ,Dut
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ Zl,•CCI
Ir ckivi T NUMBE?
02* *20600
*20600 V)
*206006
B *0.00 0
634.92
06-26-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06-12°6'-80 63'5.02 *206,002j
DATE ISSUED PERMIT NO. TOTAL
M
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1132I
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KGri.h'r 4`3
151.A6_, lort
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