1980, 03-04 Permit: 80-1763 Residence•
r
rPLAr4 NUMBER
2-51/
APPLICATION/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. RC, /
LOT BLOCK
2.
'7 LI
3v u5`
SUBDIVISION
MIOiLwtiP n,e r
LEGAL DESCRIPTION - SEE ATTACHED
ADDA!
3
OWNER
iU Q. S' oL.
51.300 We.
We
ADDRESS
Seg b Sir, A Al
CONTRACTOR
SSC
PHONE
922—ya2s--
ZIP
?PAO
PARCEL NUMBER/S
PO t770#0 o f 33St// • ?co
Required Set Bafks in Feet
/
North /S South 23
East d 'West—lad
—
• PHONE
Size of Parcel
Six13a'—
Zone CI ssification
GI1.CIL6. 11tH
ADDRESS
•
ZIP
Type Const.
v -N
Occupancy
Sprinklered
GVes ZNo 0 Req'd
DESIGNER
PHON E
ZIP
Va l uatiqn
0
DWL A+eaI B sement Area
P .2e 1/117(dij�
CHANGE OF USE FROM
6.
TO
Building Area in Sq. Ft.
GaragJ Area
ADDRESS
Storage
Split Entry Spit ( Level
Ra her
TYPE si<NEW
7. OF 1�
WORK *BLD.
❑ ALT.
❑ PLMB
O AD N. 0 RPL. ❑ MVE.
❑ MECH: I] M.H. '❑ POOL
0 OTHER
No. Baths
2i
No. Floo
1
No. Room
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd
Recd
Not Req'd
DESCRIBE WORK
6. C/A/64L P6ni!7
VALUATION
9. TA_ vo-
inen ic4 1.11/774 : Stt 4717tilw 6 6t.
Source GAS
of
Utilities
ELECTRIC WATER
/A/h#A/D /YIODnt
SEWER
Co
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.
DATE o7'sZP-J nSIGNATURE G
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Ent Health
ye
Planning
Fire Marshall
Co. Engines ey
Utilities
r/
6
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
OW MAP IV
t/ 5
FL..Ais tNCi Foo I
itAkis ft rAc+ o
J—egi1c2,R get V
4 LkMS 1'/ I mse �f�
DAT E2rZ2)�o O F FI CIA LJLNiiNM/
110 rel
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building /Z
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
it
PERMIT NUMBER
go -1763
DATE 3—`f —84
02* *28-00
*28600
*286006
E *000 8
1762E
'03.-010-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
(�,_t;.41_or
ta „Cr.
176,32 -*2860,0;°r
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