1980, 06-04 Permit: 80-5357 AdditionPLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
rAWNER
3. x.1 -
ADDRE
4. —
ADD
DESIGNER
5. ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS -HARD TO MAKE 3 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
UB I ISI PARCEL NUMBER/S
PHONE
e ZIP / Actual Set Backs in FeejC�' .;, y
North South i/ Eai�/ West
PHONE Size of Parcel Zone Classification
.i) ,x 40 "
ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE Valuation Building Area in Sq. Ft.
fid,
ZIP Main Floor I Upper Floors Garage Area Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
s.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE ❑ NEW ❑ ALT.
AQ AD'N. ❑ RPL.
❑ MVE.
7, OF
1:1 OTHER
1:1 BLD. 1:1PLMB.
1:1MECH. ElM.H.
El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DSCRIBE WOR
Enum. Dist. Location (Area)
FEES COLLECTED
V LUATIONJ SOURCE I GAS ELECTRIC WATER SEWER Ownership USE CODE
9. UTILOITIES Public El Private Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included J
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this *� 7 ik
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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 INSPECTIONS Plumbing
7 '
DATE OF APPLICATION ""��� SIGNATURE OF APPLICANT' __ L�_ /i2 Mech.
SPECIAL APPROVALSSPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
iulriina Technician..
�/�i�/.�_,�r J�R'f!�_�✓?.""YLX.�,.%��'"d'L�%L, rryLC�✓a✓it-�ri4�
PERMIT IC NIONITRONCFFPAR[ F
Plan Check
SEPA
Mobile Home
Other (Specify)
,�J J
TOTAL $
0 2*2700
* 7 n.
(i li
v 5, 6
Ob -C4 -d0
5.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
*77,001' , -
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