1980, 07-10 Permit: 80-6917 ResidencePLAN NUMBER
0'
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.
JOB ADDRESS
S:i7Z0
E ce,e/vs Ro •
LEGAL DESCRIPTION — SEE ATTACHED
2.
LOT
8
BLOCK
z
SUBDIVISION
C/ 7/1 44:31A101 5 , 4o,
OWNER
3 /�/C 6,//1/130y1O/7/ CO/VSTeVCTrevu
ADDRESS
.8414'. "OW
PHONE
?eq. X583
PARCEL NUMBER/5
2654'/- 2205'
ZIP
9W4
Actual Set Backs in Feet
North 2 / 'South %Z
East 3S Iwest /4=V
4.
CONTRACTOR
S/ 1116 -
PHONE
Size of Parcel
9/X/84/
Zone Classification
-S? *. ce F/4"#/“..SI
ADDRESS
Sfrieite.
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
ZIP
Valua i'on
.s-7, /co
Main Floor
Building Area in Sq. Ft.
/9/c
Upper Floors
Garage Area
S28!
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
/2U
Finished Basement
Unfin. Basement
`76-0
7.
TYPE
OF
WORK
,NEW ❑ ALT.
/
l BLD. 0 PLMB.
O AD N.
O MECH.
O RPL.
O M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
No. Stories
Z
No. Rooms
8
No. of Dwellings
i
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. /41667 F,P e.
/
VALUATION SOURCE GAS
OF
UTILITIES
Enum. Dist.
Resiostice
ILocation (Area)
S7,1 vc,
ELECTRIC
WATER
SEWER
SEPT/c
Ownership rel USE CODE
Public ❑ Private
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 co truction or -e
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
7;'i
7 9ning
Fire Marshall
:o ( gin G/i/ ," `7/i/!/
Utilities /
Plans Examiner
T) PO n . W "7 7/'°
SEPA Checklist
Buildinechnician
2/7/c
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
de4f-zt.e_rzity-4--fiym-AiAgt.:,
f1/4)0 c -O P a P-i*5
•
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
*307. ar,
Mobile Home
Other (Specify)
TOTAL
$ 307•er,
PERMIT NUMBER
�a- 977
C2* *30700
*307,00
*307.00
E *0.00
67&6
07-07-80
6479:
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
69175 *307.002
DATE ISSUED PERMIT NO.
TOTAL
4.
•
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