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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 O U N