1980, 11-25 Permit: 80B-4259 Residence[PLAN NUN'BER
/ =2673 t"//s-o
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 ADDRESS
/
7.4 BLOCK
B
DI
IS
3.
0
NE
cqsW4-dU
DRESS
TRACTOR
4A. «f8'DRESS
-�
PHONE
9'-787
ZIP
99a/G
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 34644 7 g
kDT .5043 vA. PaR7 of T/?AcT
// ET FARMS/RR • TWP.4e75
Actual Set Backs in Feet
North3...3 / 'South`30
Size of Parcel
East % 'West
ZIP
Type Const.
V `lam)
Occupancy
(Z_
Zone Classifications ,�j L
Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
5' ADDRESS
PHONE
ZIP
Va)Jation �v
.3/zip
Main Floor/
Upper Floors
Building Area in Sq. Ft.
/D h44
Garage Area
Storage
6.
CHANGE OF USE FR1M
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
TYPE
OF
WORK
NEW
I BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL. 0 MVE.
0 OTHER
❑ M.H. ❑POOL
No. Baths
L
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
x
D CRIBE-AWORK
%
8. %46. -
.rte
✓ LUATION
9.
Enum. Dist.
ILocation (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private 14
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 //-21-sed SIGNATURE OF APPLICANT'S
SPECIAL APPROVALS
NAME DATE
Env. 1'i5tflth
Planning
€/ //ail
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
M f?G TLS 1rJA1"r I Y2LI 0
SEPA Checklist
2din9Ten
SPECIAL CONDITIONS:
Ca.P�,LeAt-71-c-
9.'O6A /I
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $ .q
Building �/ /�
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
" ._//'
TOTAL
PERMIT NUMBE),t
0 2 *
® 0 ~
53
11 -2'5-80
6/79.
* 211,00
* 2'1100 N-
i 25.8
1 1 -2E-80
6,4°79,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.11_25
DATE ISSUED
PERMIT4 ?) �Q * 2.1 1p0
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