1980, 01-28 Permit: 80-593 Renewal of N0150PLAN NUMBER
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
l
LEGAL DESCRIPTION - SEE ATTACHED
JOB ADDRESS 1 I \ .,1..]f.>vl.t�r' ik
LOT BLOCK 5U=DIVISION
2.
3
4.
OWNER P.. .Q r
ADDRESS • f 1 4 1 a
CONTRACTOR 1.P_ 1�,1
PHONE
h31V
ZIP
PARCELNUMBER/S Oct 110c
V
aR.erg 1 C'o.A.....act sP 4t ct
Required Set z - ks in Feet
North Ai_ i r
s. S1 'West
PHONE
Size of Parrel
90-tsD'
cation
ADDRESS
ZIP
5.
DESIGNER
PHONE
Type VI t.
Valuation
Occupanyy Sdrinklered
eq .
ADDRESS
ZIP
OWL Area I Basemen
CHANGE OF USE FROM
6.
TO
pl it Entry.
Building Are, in Sq. Ft.
U to �c g --9l %f %
Staragp
Area Garage Area
Split Leer
Rancher
TYPE
7. OF
WORK
NEW
BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH
❑ RPL. 0 MVE.
❑ 0 POOL ❑OTHER
No. Baths
No. Floors
No.Ro s
Rec. Ro
CERTIFICATE
of EXEMPTION
Req'd.
Re
Not Req'd.
DESCRIBEnWORK
8. tC42.arolct_i2.
VALUATION
9.
by u roe
of
Utilities
AS 1 ELEOTRIC
WATER
SEWER
I hereby certify that I have read and examined this application and have read
on reverse side, and know the same to be true and correct. All provisions of
type of work will be complied with whether specified herein or not. T
to give authority to violate or cancel the provisions of any other stat
performance of construct:
D�E
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIA
he o ICE" provisions included
ordina governing this
a per ' es not presume
w re._ la ' •.nstruction or the
ONS: •
.,b c .
QSA".D.A.k) 1 0.c.(2 O,u\
APPROVED FOR ISSUANCE
DATE -R0 OFFICIAL
FEES COLLECTED.
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE
0'2* *2000
*2000 >n
59.2E
01 =28'-80
a 6479.
WHEN MACHINE VALIDATED IN THIS SPACE, p
THIS BECOMES A PERMIT. *00.�;o.J
ia-
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