1980, 01-14 Permit: 80-0137 Move MeterPLAN 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 4 COPIES
iOB✓arm----c
1. k /d/0
L_ i I BLVCK SU3DIV1`
OWNET &e
ADDRts�
2.
DESIGNER
5. ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
535-7`%/
ZIP
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
DESCRIBE WO
8.
❑ ALT.
❑ PLMB.
PHONE
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South East 'West
Size of Parcel Zone Classification
V I- 1 o 1 O
ZIP Type Const.
9'12-01
PHONE
ZI P
TO
❑ AD'N.
❑ MECH:
r❑ RPL.
M.H.
VALUATION f source ur�S
of
9. Utilities
MVE.
❑ POOL
❑ OTHER
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
ELECTR1L
7'V1,4�. /x'121 i�
ATER SEWER
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.
DAT
DEPT.
tc��9�'O
SIGNATURE
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
/.54--87e
DATE 0FFICIAI1 141.
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
30- "1'37
DATE ?/
it fl (Ter
4* *600
*6.00
*6006
E *000 8
13.62
0,-14-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE, L
THIS�FiCIO�E A PoE�RMIT. 1 z 7 * 6, Q 0 1