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1980, 10-22 Permit: 80B-3043 ResidencePLAN NUMBER 1 o/f3 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 7 ADDRESS 1. Z.ZUZ, Ce-LavCJ LEGAL DESCRIPTION - SEE ATTACHED LOT 2. / BLOCK SU` DIVISION ea.i OWNER 3.-eits ADDRESS s iia a4C -- fii'. Ore (9/Adteld CO TRACTOR A�4.RESS DESIGNER 5. ADDRESS PHONE 9.2€--- /3 ZIP 99'.17 PHONE PARCEL NUMBER/S.2.5-6-41- v401/ ,ADT RIoli,eivivr,EsrM7..s .� Actual Set Backs in Feet I / North 7g' 'South /© 4'East 4 West Fr Size of Parcel / APP ZIP PHONE ZIP Type Const. Occupancy n�3 Valuation 7�60 Main loor CHANGE OF USE FROM 6. TO TYPE 7. OF WORK ❑ NEW O BLD. ❑ ALT. ❑ PLMB. ❑ AD N. ❑ MECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER Area of ecks 3a 4 No. Baths 3 Zone Classification J. prinklered ❑Yes ❑No ❑ Req'd. Upper Floors l615-&, Building Area in S. Ft. jg.3 v Garage Area Storage Finished Basement Unfin. Basement No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Recd. Not Req'd. DM.CRIBE WORK 8 /b./it-age, VA UATIOSOURCE GAS ELECTRIC WATER SEWER 9.7/ z 6° OF UTILITIES Enum. Dist. Location (Area) Ownership Public 0 Private 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 cotruc,a_or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO DATE OF APPLICATION /7,'- 2e2- "- SIGNATURE OF APPLICANT X FEES COLLECTED Single Building bing Mech. Plan Check SEPA Mobile Home Other (Specify) SPECIi\L APPROVALS NAME DATE Env/ H4alth PI3nning Fire Marshall Co. Engineer Utilities Plans Examiner -TOM Pas1t wArr IA1z-ftfo SEPA Checklist B (ding Techniciapl SPECIAL CONDITIONS: 37411 OP,N —42 T PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE TOTAL PELMIT NUMBER F-- 3 ora -3 3 02* *349,00 *349.00 *349.006 /A *000 304,2 10=31-80 z 6,479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 10i 11:-f80, 5'0'43'2` 349.008'.1-2 - DATE ISSUED PERMIT NO. TOTAL I >