1980, 06-04 Permit: 80-5378 ResidencePLAN NUMB/2
APPLICATION/PERMIT
SPOKANE COUNTY BUILDING CODES DEPARTMENT
NORTH 1311 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
IIIIMMI11111101111M1d,
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
9,1?Nig R&.BLOCK SU D SION
" 14440-4Ct Polatr.e.
1.
LOT
2./Z
OWNER
3
+(Q. A -IA CA CLA .01Z1 r
e4-1,4).(4 /4,11el4kt,
DDRESS
4. -
CONTRACTOR
A.4//./L/
DRESS
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
.2* -366i
ZIP
9f A-5 7
PHONE
PARCEL NUMBER/5 ,c1, ,i.,4 i 0.0_1
Actual Set Backs in Feet
KA:7' 1-tkk 1:4(LCeri. 3% ezt,..*ka
1
North jgf 'South ..I, / East ..7,e5" IWest 3
Size of Parcel Zoe1 Classification
ZIP
/13 X iLO
Type Const.
Occupancy
DESIGNER
PHONE
5.
ADDRESS
ZIP
6.
CHANGE OF USE FROM
TO
Valuation
Main From/
ei -66
Area of Decks
.2.40
prinklered
DYes ON° 0 Req'd.
Building Area in Sq. Ft.
Upper Floors
Garage Are
6 7
Finished Basement
52,1,01
Storage
Unfin. Basement
77,
TYPE
7. OF
WORK
l>1 NEW
0 BLD.
O ALT.
• PLMB.
O AD'N.
O MECH.
o
RPL.
o
• MVE.
O POOL
0 OTHER
No. Baths
-.3
ESCRIBE WORK
141-2L/4/22,/
'e. A9 Lek Curlit/Cha
ALUATION SOURCE AS ELECTRIC WATER SEWER Ownership USE CODE
40 OF Public 0 Privet
66...e.446 -----UTILITIES Ar
I e
here/by 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
1
SIGNATURE OF APPLICANT A-.,__,
No. Stories
No. Rooms
g.
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. Location (Area)
DATE OF APPLICATION 5- - (23 —g4,
Req'd.
Recd.
Not Req'd.
SPECIAL APPROVALS
NAME DATE
AnninEnv. alth
PI g
.23
Fire Marshall
Co.
UtiIi
SPECIAL CONDITIONS:
Plans Examiner
6)
--r-i)m --r-r-t_plohri- ieTt
SEPA Checklist
"UPROAVI PET WOVID"
thce
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PEMIT NUMBER
50 -5
*:534,00
02*
*33I,00
*334,00,
E.
537. 7 *aco
06'-04-'80
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
a 0 4-8 0
DATE ISSUED
5 Z 8 * 3 3 4. 0 0 -
PERMIT NO. TOTAL
± z
141):: 0?T'OPriL.lM-1,