1980, 04-07 Permit: 80-3135 ResidencePLANRMBER 9 _ J
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES'DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / 15119) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 -COPIES
JOB ADDRESS
t. S. 4310 N6LL.ov,J St
LOT SUBDI ISION
2. .3
OWNER
3. RDY i+. ERIcKSbrl
ADDRESS
E. I 11/5- 45' i i+ A -U.&
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
Fog E s MEADOWS / ST ADDmnPJ
PHONE
`126— 3oS2-
PARCEL NUMBER'S 33Sµ3 - 13o5
ZIP
99zoG,
Actual Set Backs In Feet
North 'South
East 'West
CONTRACTOR
4. SAME,
ADDRESS
PHONE
Size of Parcel
8o X 22-0Sn1
ZIP
Type Const. • Occupancy
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
5' ADDRESS
PHONE
ZIP
Valuation
53: 17 x
Main Floor Upper Floors
/248 9-72.
Building Area in Sq. Ft.
2,4-9
Garage Area Storage
(076 —
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE L9' NEW
7. OF
WORK t4OLD.
❑ ALT.
❑ PLMB.
❑ AD N.
O MECH.
❑ RPL.
o M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
6
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. ILESIDk Nr E— <(t12.Ac1r �.
VALUATION SOURCE I GAS
OF
9. UTILITIES
Enum. Dist.
A-rrAck j,
Location (Area)
ELECTRIC
FA
WATER
SEWER
Ownership
Public ID Private 0
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 INSPECTIONS
DATE OF APPLICATION /7 OQ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env; .�
Planning 44
re Marsha 1
Co. t•in--r
Utilities
Plans Examiner
•1* •
SEPA
�'irii
SPECIAL CONDITIONS:
3-a7-80 ab
-'L
ecklist
2
11)
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
$
0
3ol0hx
O
TOTAL $ 361 Xk
PERMIT NUMBER
/35
02* *301.00
*301.00
*301:006
E *0.00\ 8
313.42
04-07=8,0
2 6479.
WHEN,MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE-ISSUED
IE 30 -LO 0a°p'-
PERMIT NO. TOTAL •
I m
E
SE WE411-
0
0
/26/
I in
• ' 2 !. EC -s le .00 rt .
Lor 1,3'
'2o4.5-0 Fr
FT'.
!')
rY
1
- 2_0
30
• 1
•
L (DT -14- 4
41 T
0"
OFFICE OF THE
,SPOKANE COUNTY PLANNING DEPARTMENT
o_!dim Codes apartment _
ram Planning Department
ubja<t _ Bulldrng_Pernut
I 4.
0
Data
March 27 19 80
The Planning) Department has received u request from
Roy H. Erickson tor the releose
of a building permit on the property as described on
the attachqd affidavit/legal description. It hos been
determinerh that a building pernut should be issued
under the provisions of RCW 58.17.210. This memo
and attached affidavit/legal description must accom-
pany the building permitapplication.
AFFIDAVI •""'No jJ OA iia
1, Rov H. Erickson vU
hereby certify that 1 purchased the following described real
property:
Lot 3 Block 4, Except the South 15 feet, in Forest
Meadow 1st Addition
in 19 80 , that at the time that I purchased the above des-
cribed property, I was unaware of the fact that the property
had been subdivided in a manner that did hot fully comply
with the provisions of RCW 58.16, et seq. or RCW 58.17, et seq.
DATED this 27 day of March
Name
, 19 80,
�. H C Cc.F!/iXet,
11115 E. 44th
,dress
SUBSCRIBED and SWORN to before me this
March 1980,
27
day of
Notary Public in and for thS ate
e
of Washington, residing at Spokane