1980, 03-13 Permit: 80-2197 ResidenceAPPLICATION/PERMIT
SPOKANE COUNTY — BUILDING. CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1.
LOT
2.
BLOCK
SUBDIVISION
3
4.
OWNER r
ADDRESS � l
CONTRACTOR
7SC04 p�y LI��
`01W1
ADDRESS
M'IPiL,a'j5
PHON
9 -4398
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 2..�'South 1'2 East
West "
PHONE
Size of Parcel
ZIP
DESIGNER
5' ADDRESS
PHONE
ZIP
CHANGE OF USE FROM
6.
TO
Os X /3�r APf1poh'
Type Const. Occupancy
V -N p_,' 3
Zone . ssificaiinn
Sprinkleretl
❑Yes DNo 0 Req'd.
Valuation
DW`3{800-
Area I BasetaAre�
104-0 IJ (7 •I "GrU11Jl�j
Split Entry
BuiltlingI Arta n Sq. Ft.
Garage Area
Storage
Split Level
Rancher
TYPE LVINEW
7. OF
WORK '� oLD.
O ALT.
O PLMB.
O AD N.
O MECH:
❑ RPL.
❑ M.H.
❑ MVE,
❑ POOL
0 OTHER
No. Baths
No. Floors
No, Booms
Rec. Room
• CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
ESCH'S WORK
8. D�'II it %AMl H'Svc�l`j� A&� 1
VALUATION Source / GAS' ELEC RIC
of
9. Utilities
WATER
MOn� 1Kit
SEWER
I hereby certify Ghat 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 b r a.�y regulating construction or the
performance of construction. , -----` T / / $
DATE �R, �D/(l.O SI a'N'ATURE __,.1.�I� iTn
DEPT.
SPECIAL APPROVALS
REQ'D.
REC'D.
-�---•"SP ECI ONDITION§:
cc j -r Ltc �SG-A4,- t, 3zz-i k )
fociP-r krtiv-i-H3o
Env. Health
avti CI,MND
Planning
4214,2g,0
Fite Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
YES ID
I HOME OWNER'S WARRANTY
NO 0
"APPROACH PERMIT REQBIREIY'
Ce ;Fact County E::;ineer's Office
PANS hPPuVrs.�+�'�-^ r(/
DATE 3-12_8D OFFICIAL Lsal
APPROVED FOR ISSUANCE
- FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
.2-5S
SEPA
Mobile Home
Other (Specify)
TOTAL
$
ft
PERMIT NUMBER
t — 27V-7
DATE
'02* *25500
*255.00
*255006
'*0.00
201.28
03-.10L80
6,479
n
i
CC
0
— w0 -
Z
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 a.' $`'0° 2 19,7 5 *25'5.0'0,20
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