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1980, 04-29 Permit: 80-4082 ResidenceLAN Ni�'ME3�-R� ��CC//�JJ 5.. APPLICATION /PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DESCRIBE WORK 8. ry T=Am►L. —Pe t© VALUATION Source GAS ELE TRIC WATER SEWER of Utilities 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 constr ction. � DATE v SIGNATURE DEPT. Env. Health _ Planning _j�l Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist AL APPROVALS REQ'D. RECD. SPECIAL CONDITIONS: FJIv 5 �iC'Ac+� �I, ic--m(weD CoIvCY2>r4cT04Z Contact County En&eeir's Office P� 4� P -Z�'� Z� 1 DATE OFFICIAL Annnnvr IPQIIAMPC FEES COLLECTED Single $ Building Zdl •� Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ WHEN MACHINE VALIDAI THIS BECOMES A PERMIT. �u PERMIT NUMBER DATE r• V 'ACE, } APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES ,. Jo ADDRESS �, -3Q) L vac -,lei LEGAL DESCRIPTION — SEE ATTACHED LOT BLOCK PARCE,L/ NUMBER/S 2. I ISUBDIVISION /yjEj FT pg S393, '70r- r or C-1-1 Kr o'er owPHONE �—� PHONE 3. �-- AD ESS„nn ZIP Required Set Backs in Feet / C-�j/�ZL+ - �� cf) North 12 South - 3+ [: East ZS` West -151 CONTRACTOR PHONE Size Zone Classification Marcel 4. ADDRESS ZIP Type Const. Occupancy Sprinklered r� I ❑Yes ❑No ❑ Req'd. DESIGNER PHONE valuation Building Area in Sq. Ft. 1800. oa 77-70 5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage C( Z' 3381 --- --- CHANGE OF USE F OM TO Split Entry Split Level Rancher 6. V11 TYPE WNEW - ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. NoI . Baths , No. Floors I No. Rooms A Rec. Room — 7, OF �/ ElOTHER Sr BLD. 1:1PLMB. ❑ MECH: ❑ M.H. El CERTIFICATE Req'd. Recd. Not Req'd. WORK of EXEMPTION I DESCRIBE WORK 8. ry T=Am►L. —Pe t© VALUATION Source GAS ELE TRIC WATER SEWER of Utilities 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 constr ction. � DATE v SIGNATURE DEPT. Env. Health _ Planning _j�l Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist AL APPROVALS REQ'D. RECD. SPECIAL CONDITIONS: FJIv 5 �iC'Ac+� �I, ic--m(weD CoIvCY2>r4cT04Z Contact County En&eeir's Office P� 4� P -Z�'� Z� 1 DATE OFFICIAL Annnnvr IPQIIAMPC FEES COLLECTED Single $ Building Zdl •� Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ WHEN MACHINE VALIDAI THIS BECOMES A PERMIT. �u PERMIT NUMBER DATE r• V 'ACE, } • a 0 1\ 16 ,-roLrz.E. rti 0 ) -,thD rn -�, 0 I,