1980, 05-13 Permit: 80-4709 Remodelki{ IPLAN NUMBER a
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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 BLO ADDRESS_
1.11_117(
K ,UtB IV IDSION AC J Q
2. A.9. u
3. q�7 a ��� A/CLQ GGy hl.�(��.
ADDRESS
/ 76.2 U
CO TTTRRACCTO �R
4.
Agp
DESIGNER,.
6. ADDRESS
PHONE
926-x7
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S 2(05.2.-3307
LOT 7 23L.K Q 2
.'AR,LY DAWN ADDrriaN,
ZIP
99637
PHONE
Actual Set Backs in e -b •
North 'Soot 2, t West
Size of Parcel
70 X/35
ZIP
Type Const.
Z ne Classification
•
Occupincy s' Sprink ered
❑Yes ❑No 0 Req'd.
PHONE
ZIP
Vagiation D
4/24
Upper Floors
Main Floor
BuIIdIng,Area i Sq. Ft.
3/5 no REMODEL
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
A /.5'
Unfin. Basement
TYPE
7, OF
WORK
❑ NEW
O BLD.
O ALT.
❑ PLMB.
O AD N.
❑ MECH.
ESCRIBE WORK
?ALN
'VALUATION
/,DODO
..
(A
❑ RPL. 0 MVE.
''7q������ tom
OTHER
❑714""4" �l DOPiLJ•LO"RCti
SOURCE
OF
UTILITIES
WATER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Enum. Dist.
Location (Area)
Ownership
Public 0 Private
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 INSPECTIONS
DATE OF APPLICATION 6--/3 - sD SIGNATURE OF APPLICANT
a:
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu�ldi nanizn
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Not Req'd.
X
FEES COLLECTED
Single $
Building/ 7�
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL /7�'
PERMIT NUMBER
so - H 7d C1',
02* *17.50
* 17.50
* 17.508
B *000
470.8
05-13-80
B 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'05-' "1'3':: 8!0
4'7'0.92 *17.502' -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL