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1980, 10-16 Permit: 80B-2088 ResidencePLAN NUMBER lir / o/1i6/ 8'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 4 COPIES JOB ADDRESS 1. 3s A r i jL Zv rv.% Qc, c. -d LOT BLOCK SUBD',VIS.ON 1 Stew° P P trs`k- Add i♦rein PHONE 9.2.2-17c6 3. 4. OWNER 5: 550C- LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S ADDRESS Mao Is* Src 4. atm e_.. CONTRACTOR ZIP Required Set Backs in Feet North 3 ft7 (South 3 a East 3 West l / PHONE ADDRESS DESIGNER ADDRESS 6. 7. CHANGE OF USE FROM TYPE OF WORK XNEW ❑ ALT. ❑ BLD. ❑ PLMB. TO ❑ AD'N. ❑ MECH: ❑ RPL. ❑ M.H. ZIP PHONE ZIP ❑ MVE. ❑ POOL ❑ OTHER Size of Parcel Zone Classification , 45 k !!/• 5(, Sf7414., ly Type Const. Occupancy Sprinklered V— j4 P.-3 ❑Yes 'gkNo ❑ Req'd. Valuation i� Building Area in Sq. Ft. 388a Split Entry No. Baths .2 Basement Area Garage Area Storage 1,3 DoJE Ranche Rec. Room N r� CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. DESCRIBE WORK ® 8. te., ( IL.KA,� S^ res Q/ t'.,I,�c -- VALUATI "'� of" of 9. 3L, O o©. Utilities GAS !)Cf f ELECTRIC arc` WATER 0A_ SEWER Sr p+,1c..., cL ckka�d �- o qc�ra 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 e g :ntin. of a permit does not presume to give authority to violate or cancel the provisions of any other ate or loc. law gulatiL•onstruction or the performance of construction.r DATE C� l 'JO SIGNATU DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Hea Planning g-�-�P-La /.3 Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: PI—A11/41S DK. A// DATE 70-5,-n OFFICIA L}% % , ^t/,d APPROVED FOR ISSUANCE FEES COLLECTED Single $ [j Building Irk Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ PERMIT NUMBER DATE l0 —7-- le) C2* *21500 *21500 1,75 *215008 P *O.0O 208:72 10-16-80 2 6.479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 0 d.6`-�802'0&82 '15.00°P' (1- DESAC E 1 1C, 7" F-411 . ,J -- • R _ 2.3651 -4L\11': -K413 (:)5 is;?' Ar 1 n