1980, 12-02 Permit: 80B-4358 Residence/ 02/02/ OC,
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
1.
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3.
4.
l'ix4°N)101.i �-
PHONE
92l--
ADDRESS
1-6)• E 14- k 4 -
CONTRACTOR
PARCEL NUMBER/S 5-641 - 050 3
Actual et Backs in Feet
North 'South 8
East 3 2 (West 5-3
PHONE
Size of Parcel Zone Cla sification ��� �j
133.140 X (%-`.5A; IgAe( � i v"
ADDRESS
ZIP
Type Const.
V -N
Occupancy
r2.
Sprinklered
Des ❑No ❑ Req'd.
DESIGNER
5' ADDRESS
PHONE
ZIP
Valuatigpt.
(9
Main Floor
19q-�
Building Area in . Ft.
Upper Floors Garage 7a2
�7
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
336
FinishedBasement
Unfin. Basement
g0
TYPE
7. OF
WORK
,-/� W ❑ ALT. ❑ AD'N.
LJ BLD. 0 PLMB. ❑ MECH.
O RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
No. rigs
No. Series
No. Rooms
No. of Dwellings
I
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not7q'd.
B WORK
8. DE�IIIVI�L 'I'IVI vi/ ��
VALUATION SOURCE GASELECTRIC
OF k
9. UTILITIES 1/ �j �
Enum. Dist.
Location (Area)
WIjTER
WIVC
SEWE
R
Ownership
Public ❑ Private lel
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
performancc of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
0
SPECIAL APPROVALS
NAME DATE
Env. ealth
Planning
Fire Marshall
Co.m $,/
r„,
Utilities
Plans Examiner
SPA Cb�ec lis
1rAuto /IQ
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
ri-
r I - - 62 J 9-)
f
1-1,cv4
r
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 $
PERMIT NUMBER
;,c* *38800
*38800
*38800
F *0.0
l- J
12-02-80
6479,
u
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
121 & Zl_l8 •O
DATE ISSUED PERMIT NO.
41:581 *318.0040 -
TOTAL
* P I