1980, 11-18 Permit: 80B-3928 Repair Fire DamageAPPLICATION/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
LOT BLOCK
BUCkE
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISIO
OWNER
.S—rE.Vg. WOW,
ADDRESS
S'.2— 13 Bi.1c.KCY/E---
CONTRACTOR
Kik B
PHONE
PARCEL NUMBER/S 45/ -re 45 -dei — 7.6 --/74l
Z3 25 0 A- fiz 8-2i./
75.9Z— 57oz.
ZIP
Actual Set Backs in F
North 'South
1West
PHONE
8-31; -5471/
Size of Parcel
Zone Classification
46, Su /3c.• re 0/9".)
ADDRESS
308 6. ?mc,
ZIP
WeZ,Z
Type Const.
Occupancy
Sprinkiered
Yes 0No 0 Req'd.
DESIGNER
PHONE
Val Gon
.5-00
Building Area in Sq. Ft,
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
0 NEW Er ALT.
IE/BLD. 0 PLMB.
0 AD N.
0 MECH.
RPL.
0 M.H.
o
MVE.
0 POOL
0 OTHER
No. Baths
...moo Ow • • • • •
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.ee- s --
4 VALUATION
gr2, scro
1 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
SOURCE
OF
UTILITIES
GAS
Enum. Dist.
-re, - isrove; Re -s- inkFeu
Location (Area) '
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private Vei
USE CODE
DATE OF APPLICATION / /
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Builclin Technician
d..._er
SPECIAL CONDITIONS:
e'er ..FracA"
?.4//?)',Z4
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
•
FEES COLLECTED
Single
Building 1* -31:2•
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ (Do
PERMIT NUMBER
80,8- -3c1 zs
02* *3600
*3PQc
A * G 0 F
392.5
11,-18-80
:-f-3 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
, • ,
DATE ISSUED
3192.85 *38.00i
PERMIT NO. TOTAL