1980, 05-16 Permit: 80-4852 ResidencePLAN-NUMB�F,R ,n Z
/Fj I as
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
1. S .3CD
LOT BLOCK SUft9110N
2. (o 4 IAIDILome 1ST PoQs%ITtONa
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3 FALcO
ADDRESS
N : 3Sto
Co NST 2uC—C l U ti
A Itbc a CYC lS ORcHIlQDs
PHONE
qz8 zt VS
PARCEL NUMBER/S
335AA\— MCDC
ZIP
Actual Set Backs in Feet
)
North !South 11
East G6' 'west -S.S1
4.
5.
CONTRACTORa
Sme
ADDRESS
SAyme
DESIGNER
PHONE
Size of Parcel
c34x 13S
Zone Classification
SiNCtLE R4/4111...•/.•/
ZIP
Type Const.
Occupancy
Sprinklered
Oyes ❑No 0 Req'd.
PHONE
Va ation
7Z coOO.00
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Flobr
124({
Upper Floors Garage Area
1244 5 28
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
33(a
Unnfin..p Basement
TYPE
7. OF
WORK
Pf NEW 0 ALT. ❑ AD N. 0 RPL. ❑ MVE.
BLD. 0 PLMB. ❑ MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
Z
No. Rooms No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not R;q'd.
DESCRIBE WORK
$• SINGLE VAnnu.. / KeSIOE/VCe
VALUATION SOURCE GAS ELECTRIC
OF
UTILITIES
a 0000.-
1 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 II��II regulating co. ? ur.- -
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECT j( / Pt"
��Z� /r�rI %J/
DATE OF APPLICATION SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
ATER
SEWFr.R
Enum. Dist.
Location (Area)
Ownership ,-y
Public 0 Private to
USE CODE
SPECIAL APPROVALS
NAME DATE
Env. He
Plan Ing
Fire Marshall.
Co. Engineer
Utilities
Plans Examine
• .y _ Il
SEPA Checkli
Id l,• Technician
MLiss—TS INCNc
• PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 352.LDD
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
•
Other (Specify)
TOTAL $ •CID
PERMIT%':UM.E"
go- /18:5—.R
02* *35200
*35200 b5
*352006
B *0,00
4.851
05=16-80
2 4479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1).5i ;11;"6!4`.8;0 4.8'5,2 5 *55 240,0 2 RI -
DATE ISSUED
PERMIT NO. TOTAL
0-
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LL
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5'
7
4
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C-.paa4s,
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