HomeMy WebLinkAbout1980, 09-11 Permit: 80-9976 MHPLAN NUMBER
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.
JOB DRSb
I,to ,I_ ,ri
LOT ���'p`P
BLOCK
SUBDIVISION
3. oW:61-I1.I ++. Roz.
ADD_RSS-2_O
CONT A iqR
4. •.ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
P
'r%
Z-5195
PARCEL NUMBER/SAy��i1 Z' or 044 43 X34
IJP -n -f 176
IrrVVor .
PHONE
Actual Set Backs in Feet
North 'South • (East
Size of Parcel
17O X 1 b
(West 26
Zone Classification
ZIP
Type Const.
-14
Occupancy
2-3
Sprinklered
❑Yes ❑No . ❑ Req'd.
DESIGNER
PHONE .
Valuation
ADDRESS
ZIP
Main Floor
Upper Floors
Building Area inSq. Ft.
Garage Area
Storage .
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
to NEW 0 ALT.
❑-BLD.= ---- ❑ PLMB.
❑ AD'N.
O MECH.
0RPL.
LrJ . H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
2
No. Stories
I
CERTIFICATE
of EXEMPTION
No. Rooms
3 -
No. of Dwellings
Req'd.
Rec'd.
Not Req'd.
i
8. DESCprE Wirc, Holm4.
) WAT R
MII;DUI
VALUATION
a JOI 000
SOURCE
OF
UTILITIES
GAS
ELECTRIC
Enum. Dist. I Location (Area)
SEWER
Ownership
Public ❑ 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 (�/ /�/ U U SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
?— e
Pia
Fire Marshall
Co. Engineer
Utilities -
Plans Examiner
SEPA Checklist
Technic
SPECIAL CONDITIONS:
d rev P 01.46 . C 121415)1212) o� T-ri9)
.�.,'.`
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES'ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
FE
RM1T ?i UMBER
ea-, 9g7c
0.7* *500.0
*5'0;00
*500.08
A.*000
997,52
09=1'1!,80
2 6,4.79,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0;,9'! O14
DATE ISSUED PERMIT NO.
9.9 Z.6'2:
TOTAL .'
J _ -I
I l I I ' 1
-1 --%- .-- -- 1
- I : -- a-- -j _ ;. . I i - i t_
_17v_ O-_1
13 l oG $ . _.
_1 t
1
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1
1 4
. ; _ ; --i.- i- I 1-., -{-
,-
I ; { I 1
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I t
' 1 1
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I I I
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;
1
I
1 I I
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I 1 1
I , 1
,
I
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1
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