HomeMy WebLinkAbout1980, 08-22 Permit: 80-8983 ResidencerpL E'N UL sER
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
T3 L>l �'`i'1✓2
LOT BLOC SUBDIVISION
3
OW NEtt,
JI
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S 09 5
- 15o6
ADDRESS
3//7)
CONTRACTOR
4- ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ZI P
PHONE
Actual Set Backs in Feet
ISout r'," East ' Iwest'- 2 0
North
ZIP
PHONE
ZIP
TO
EW D ALT. 0 AD N. 0 RPL. ❑ MVE.
LD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
Size of Parcel
Type Const.
r
Valuation
Occupancy
/k16TG e
Zone Classification
Sprinklered
❑Yes kr-No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
�aM�ain Floor
� Upper Floors
%73
Area of Decks
Finished Basement
Storage
Unfin.. Bent
,X
DESCRIBq WORK eISI I J p�
V9/ f i I:� I4G:/..� -,
VALUATION SOURCE GAS ELECTRIC
OF
9. UTILITIES
WATER
IJE�
SEWER
No. Baths No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
No. o Dw 'ngs
Req'd.
Location (Area)
Ownership
Public ❑ Private D. -
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 F - 9 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env ea
Planning
hee, vold
Fire Marshall
Co. Engineer
Utilities
ns Examiner
A Checklist
SPECIAL CONDITIONS:
H /j L -1l� 1
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Rec'd.
NotRegsd.
FEES COLLECTED
Single $
Building
Plumbing
flllech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
`TEFIMIT NUMBER
80 —6983
02* *2;1000
*2:10,00
*21 0.00
E *000
88672
08-2D-80
2 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08..22J8,0
DATE ISSUED
8 9 8.3 z, 21'0,0 0 2
PERMIT NO. TOTAL
1
1
•
. /
Box iso
-lR/4T[-S Rs-A*1T_�
BLi(1...o1
9e
11.()NTA cArk-.