1980, 05-14 Permit: 80-4814 ACPLAN 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 3 COPIES
JOB ADDRESS
RC1 /mss
LOT BLOCK
SUBDIVISION
OIN R
3.to- YYv.1i'�
E
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ADDRESS
l ?� If �3 s. �� A / v° i' LI
.CVTRAC OR i—
�OV/ ���i
4' ADD SS
i/, 1017
DESIGNER
;;S iO r
a-IONE
Actual Set Backs in Feet
North 'South (East West
Size of Parcel
ADDRESS
CHANGE OF USE FROM
6.
TO
ZIP
yO
PHONE
Type Const.
Occupancy
ZIP
Valuation
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Main Floo
Upper Floors
Garage Area
Storage
TYPE
7. OF
WORK
❑ NEW ❑ ALT. 0AAD'N. 0 RPL. 0 MVE.
Ltd
O BLD. ❑ PLMB. MECH. ❑ M.H. 0 POOL
❑ OTHER
DESCRIBE W RK `'�
8. i. ` e ; r\Li'E
VALUATION
9.
SOD
OF
UTILITIES
-J 1 I-\.. O h
GAS
ELECTRIC
WATER
-7
4.4457
SEWER
Area of Decks
No. Baths
Finished Basement Unfin. Basement
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
No. Rooms
Location (Area)
Ownership
Public ❑ Private ❑
Req'd.
USE CODE
I hereby certify that I have read and examined this appiication ana 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
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
Env. Health
NAME DATE
Planning
Fire Marshall
Co. Engineer
ies
Examiner
SEPA Checklist
Buildin
Techni n
No. of Dwellings
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech. / '
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
80 "4614-
04* *7.00
*700 1,5
*7006
E *0,00
481.32
05-14-80
6.479
• WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
5r.1'4;'g'0
DATE ISSUED
481.42 *7.00°
PERMIT NO. TOTAL