1980, 08-26 Permit: 80-9098 AdditionPLAN NUMBER
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f/,26/y
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 0��tV 4 ^ 1 Cu -t e - ✓A N45 I ORA,
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
3.
4.
ADDRESS 4.21 Cus er- ets 6 rN ZIP q q Za (
OWNER
TAnG-s i3L-e-rtmE
PHONE
'53S t%c3
PARCEL NUMBER/S S'. sal 0 S 0/ l✓ ofi
N W Xy or- S,o/ A, or N W'/q �Xc. W. 30' {"
EA'C. G . L •
Z 3.53x- goy!
ADDRESS S� Cc.LM v
CONTRALTO 3 P ES -BL , me.‘1714:22:L vuttirtJ
P
Required Set Backs in Feet
North j
�� 'South 8 � East %Z7 West
Size of Parcel
58 X zoo
Type Const.
Zone Classification
�v.P/GUc.7cl,PAt
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
5. ADDRESS
MJ2WAti
DESIGNER NO`L'
FG' S f), IFsn° �Sa12iltc.„
PHONE
24 -slo4L
a tion Building Area in Sq. Ft.
/e /67C, 460
DWL Area Basement Area Garage Area
580 37Z-
6 '3 4
ZIPc q I o
Storage
CHANGE OF USE FROM
6.
TO
Split Egtry
Split Level
Rancher
TYPE
7. OF
WORK
RI/NEW ❑ ALT. XAD'N. ❑ RPL. ❑ MVE.
❑ BLD. 0 PLMB. ❑ MECH: ❑ M.H. ❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
.S
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
N F3.eq'd.
DESCRIB WORK
8. MI) O% S€wre f ryi, oFft L, 1-610. a it / will a Will 1- (4 $
LUATION Source GAS ELECTRIC WATR SEWER
of J
g 6�1�� Utilities ^ � Wt' /
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 c. st uction.
DATE
SIGNATURE
1I1 11110
DEPT.
PECIAL APPROVALS
REQ'D. REC'D.
Env 1H 5a It
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL ¢ NDITIONS:
1914N‘
DATE Wre/e3O OFFICIAL
•
SEs
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building /i Z2• 470
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /2Z • Qr5
PERMIT NUMBER
- 2 6 E' 0
6 u. 7 9,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS CO E .q Erj1mIT. '9. O
( -1 (0 ''� 9082 *12'2.00x1'
:lames 81 --HAe
.ctt-Fix gal C-1-4,sfer
Spoke/14Q_, qqac,
PakeQ 4ia3532 - 6104+1
sop -tic tes
(/ace_ me
NO121-14
Caster 5+,
K
4
(-15'-4*_'----)4/CA
New) NEW
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