1980, 10-13 Permit: 80B-1857 ResidenceTrr
PLAN NUMBER-
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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 ADDRESS ��/ y�
HLGCK SUB`DIVISION
CIQe-M� tt�G,
ADQ�1 SIO I c*
CO N 4-43
TS"%j qT
R
4. ADDRESS 3�nR��,/
1. S,
14110 JAMS l r( I-,
is
z.
OWNER
3.
LEGAL DESCRIPTION — SEE ATTACHED .
PHONE
924 '40 C°
ZIP
.9697,06
PHONE
PARCEL NUMBER/9 335.1 - "op 3
Actual Set Backs in Feet
{
North 29IS
Size of Parcel
IIOccupancy
ZIP
outh East 7 (West 1
Zone Iasslflcatlon'
k tit?
Sprinklered
❑Ve ONo 0 Req'd.
Building prem Sq. Ft.
Upper Floors Garage Area Storage
Type Const.
5.
DESIGNER
PHONE
Value on 41 1
ADDRESS
ZIP
Main Floor
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement I Unfin. Basement
I0r;<a
TYPE
7. OF
WORK
�J[ EW 0 ALT. 0 AD N. 0 RPL. 0 MVE.
0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rams
No. oftDwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not ce d.
DESCRIBE WORK
B I66,
VALUATION SOURCE G /AS�
OF
9. UTILITIES
zAarb
Enum. Dist. I Location (Area)
ELECTRIC
WATER
5�✓)/=�/W E R
t✓7✓
Ownership/LSE CODE
Public 0 Private 1
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 rlating construction or the
performance of construction. SE REV 'SE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. He..
1111111.1
Planning
Fire Mars hail
0
Utilities
Plans Examiner
05
SEPA Checklist
(ding T
SIGNATURE OF APPLICAN---
SPECIAL CONDITIONS:
Catlil LAC, (q)4,- — YI —* 24I 19N II/i5/90)
creA rr,- Yw�l-. S - R b b
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
p6
TOTAL $;to
PEB'tIT NLWBER
02* *269.00
*269.0,0 N
*269.00
A *0.0,0 8
18562
10=13-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1tD'rd 8!,0' 1r8 ::7 z *'2'6 9.0
DATE ISSUED PERMIT NO. TOTAL
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