1980, 05-29 Permit: 80-5092 ResidencePLAN NUMBER, -.
2=7
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 ADORES
f LOTBLOC'SUBa ciN
2 3 4 MII1Lo r.» �srpdr�IT.
LEGAL DESCRIPTION - SEE ATTACHED
3
OWNER �p
MA-SiTlno SL nr «V r
PHONE
q'a%- tOg`l14.t_ aka
PARCEL NUMBER/S S'l 1- 13.03
ADpR ESS
ZIP
ggac-,&,
Actual Set Backs in Feet
North to
South 211-- IEast
IWest 10
4.
5.
CONTR OR
PHONE
0—
Size of Parcel
Ptd x 1
Zone CI ssificatio
�It l Fi FAvt1&?
AO D R ESS
ICA-NVx—O
DESIGNER
PHONE
ADDRESS
ZIP
Type Const. '
vt4
Occupancy
R-
Valuate0 6
rain5 FIoc7o1
3
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area iq Sq. Ft.
1.12.P0
Upper Floors
632
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished
Basement
Unf in. Basement
I
0+0
7.
TYPE
OF
WORK
A. NEW 0 ALT.
‘BLD. 0 PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Booms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Rgp'd.
{�SCRIBE WORK
8. 1an-Qv Mf O
VA UATION
9.
SOURCE $ G
OF
UTILITIES
t
Enum. Dist. I Location (Area)
LEC/PIC
WATER
ccr1 M .
Ownership USE CODE
Public 0 Private
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 SSREVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION �+C J O 'SIGNATURE OF APPLICANT��.,�j��Z�'
SPECIAL APPROVALS SPECIALI7t`CONDIITIONNS: •' -
NAME DATE , k-' p�'TA-C, t0 _
0041
Il "I . 3/3 /81
Env
Planning
Fire Marshall
C
•
eer
77t6L0.-- / - /JL4
�I'`
Gni
Utilities
Plans Examiner
rut`s
Pa
W
SEPA Checkl
=Sal
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single,. - '$
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
3o -I
00
TOTAL $ 301/
PERMIT NefBEilt-_
LO — 5492
0.2* *301.00
*30100 16
-*301006
E *000
509.1.2
0529-80
64,79
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
D51rlr2'9;!= 8I 0: -
DATE ISSUED
50'9,:25 *:30100.° —
PERMIT NO. TOTAL
0-
0-
O
—J
LL
_._i �.,.