1980, 08-12 Permit: 80-8399 MHPLAN 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 3 COPIES
JOB ADDRESS
1. �pC
LOT fl. G('.
SUBDI VIS ON
2. I?
OWNS3
BO K
/8802
copcgu re Ifs-5In l.,
J. V4Jk1v1
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S pig 0050 -OIO
ADDS 19 (9C72 fCAC9
ZIP
alc)pn--7
4' ADDRESS
-CONN R�CTOR _
PHONE
ZIP
DESIGNER
5' ADDRESS
PHONE
ZIP
A tual Set Backs in Feet
North 3 O (South C 1 East (West IZ
Siz¢ i i Parol Zone Clas'ficatlon 14311
•
Type Const. Occupancy Sprinkleratl
❑Ves Uro U Req'd.
Valuation Building Area In Sq. Ft.
.37M Doo r
II�
Main Flodr Upper Floors Garage Area Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPEW
7, OF
WORK 0 BLD.
O ALT. 0 AD N.
O PLMB. 0 MECH.
❑ RPL.
O MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
R eq'd.
Recd.
Not ReA d.
v
DESCRIBE WORK A � .
B. M 0131.1.-.6 !-IoM %'" x "I
VALUATION ELECTRIC
9. •
SOURCE
OF
UTILITIES
GAS
Enum. Dist.
Location (Area)
WATER
�zt"1 M
SEWERS
516
Ownership J/
Public 0 Private LO
USE CODE
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. SEE REVERSE SIDE FOR REQUIRED INSPECRONS
DATE OF APPLICATION SIGNATURE OF APPLICA
SPECIAL APPROVALS
NAME DATE
Env. Health
tanning
Fire Marsha
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
a_
'i&ah --er-efre
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home 10 0 -
Other (Specify)
TOTAL $
PERMIT NUMBER
6363.833'99
07* *10000
*10000
to
83812
08-11-8.0
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
p
DDATE IStSU1
rED81O••
PER I; O'• . TOTAL
0'J.. x 9 9 *1 (1 !I n "n D.
O
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LL