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1980, 07-31 Permit: 80-7950 AC
PLAN NUMBER (V 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 1. 2. 3. JOB ADDRESS 20/`/ C /ei.'rL/ LOT BLOCK SUBDIVISION OWNER ADDRES 4. CONTRACTOR/�l /I'fJf1/C�f PHONE `72'-2‘i0 ZIP PHONE ADDRESS /37_,,e7/ /Y DESIGNER 5. ADDRESS LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S Actual Set Backs in Feet North South East (West Size of Parcel Type ZIP Type Const. Occupancy CHANGE OF USE FROM 6. TYPE 7. OF WORK .T NEW ❑ BLD. ❑ ALT. ❑ PLMB. PHONE ZIP TO ❑ AD'N. MECH. ❑ RPL. ❑ M.H. 0 MVE. ❑ POOL 0 OTHER Valuation Main Floor I Upper Floors Zone Classification Sprinklered ❑Yes ❑No ❑ Req'd. Building Area in Sq. Ft. Garage Area Area of Decks Finished Basement DESCRIBE WORK 8. VALUATION 9. eC /` e /< me/ l o/c oevietA/JAz",tiace SOURCE OF UTILITIES GAS ELECTRIC WATER SEWER No. Baths No. Stories CERTIFICATE of EXEMPTION No. Rooms Enum. Dist. I Location (Area) Ownership Public ❑ Private ❑ Req'd. 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 INSPECTIO DATE OF APPLICATION 7 ,Zq` SIGNATURE OF APP LICAN/✓eZt,11f©� SPECIAL APPROVALS SPECIAL CONDITIONS: NAME DATE Env. HF Planning Fire Marshall Co. Engineer Utilities Plans Examiner 1 SEPA Checklist Building Technicia Storage FEES COLLECTED Single $ `� Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ PERMIT NUMBER ® 04* *700 *700 N *7,006 E *0,00 794.98 07-31-80 E 6479, • WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE 07=•3,1 80 DATE ISSUED 7 915.0 PERMIT NO. *7.00aF TOTAL