1980, 07-30 Permit: 80-7880 RemodelCLAN NUMBER///77/3a/71)
iZLJ (/ I
APPLICATION/PERMIT
SPOKANE COUNTY — BU'L.DING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPJKANc, RASH INGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
JOB ADDRESS
E. ) 3)15 .2 RD
LOT BLOCK
21011(
3
SUBDIVTSION
orrorrrukIrrY - �t
OWNER
3 -O-GE W. Sc-hNE.(Ute_
ADDRESS
E• listo 13115 23 gP 5POKMiE_
PHONE
12`t -03n
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S 2754I - Z 33`71- # 33
4.
CONTRACTOR
e.--011-.Ge- B. DULL—AN-TY
ZIP
`7C(2Ctj-
PHONE
53 2476
Actual Set Backs in Feet
North 'South'
East 5 'West
ADDRESS
E 2i4-4- SJ Gr Lel
5 Po KANE_
ZIP
Y 2c3
Size of Parcel Zone lA
vd- Classification
I i'
1/ Sprprinkklered/,1
❑Yes ❑No 0 Req'd.
Type Const.
V -N
Occupancy
M-1
5.
DESIGNER
PHONE
ADDRESS
ZIP
Vaation oc
Main FI 3q (� X1L /1/
oor
52?
Building Area in Sq. Ft.
Upper Floors Garage Area I Storage
CHANGE OF USE FROM
6.
TO
7.
TYPE
OF
WORK
o NEW
60 BLD.
I ALT. 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
coytgekrea of Decks
/?2
No. Baths
Finished Basement
Unfin. Basement
No. Stories
)
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK KCNtoDEL kCl-rcF}k-IJ/D)NIN( /i121 -ii 1tfiIV DiEcg AkTTAc-(g
8.GAr..AGR.... ANI2 51.o12F 1 /\Pprflo1J To E.XS-riNG 2C. �
IPENC
. VALUATION SOURCE GAS ELECTRIC WATER SEWS
9./L/3 /c,�,b.
UTILITIES
Enum. Dist.
ILocation (Area)
Ownership
Public D Private gr
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
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION %j i 2q /q SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env.
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
r1/1 ro S7LI v WAj - 77/ ZzJa)
SEPA Checklist
ng nici
an
• 7-.,e3
SPECIAL CONDITIONS:
Z23 -D! DU-LL--ACz-1332.8o3
M/ �o cl4r41314..
6'01R T - 3 -8b
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
b6
Building 7,3) xx
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ ` (ait�c
PERMIT NUMBER.
02*
* 9800
* 9800tri
* 98006
E *C00
780.42
07-2880
6.479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 7 11, a 8.0
DATE ISSUED
%08.0z
PERMIT NO.
*98,00aF!
TOTAL