1980, 01-23 Permit: 80-477 ResidencePLAN 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
JOB ADDRESS
LOT I BLOCK SUBDIVISION
2. 2-- 2 �lH S �� iscoo
P ONE
3/4
OWNER
3. e- o -T --r ' 11,11Adbia,
AQDRESS p 1 7/T4 6
4' ADDRESS
.k
CONT RACTOL2�
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
011-1 -0V),-2--
ZIPGy. ^
`PH No 6
RequiredJ Set Backs in Feet /�
North r CC 'South 2i� East ac7 (West .3 0
Size Pf.Parce 1
ZIP
Type Const.
Zone Classificatior
10 C'I4- LXX M ;
Occupancy Sprinkle ed
Oyes UNo 0 Req'd.
DESIGNER
6. ADDREZS
PHONE
V alua ion
Builtling Area in Sq. Ft. re
ZIP
DWL Fyrea Basement Area
1000 1700-
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE IgeNEW
7. OF ry/
WORK
0 ALT.
❑ PLMB.
0 AD N. 0 RPL. 0 MVE.
❑ MECH: 0 M.H. 0 POOL
0 OTHER,
No. Byths
No. Floors
No. Ftooms
Rec_Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
9.
DESCRRIIIBBE�/WyO7yRRK� � j /V�I•�/'is�,�.��l�4 % �� yj�/��
iciA ✓'W `� RI/urce GAS ELECTRIC
VALUATIO
-of
Utilities
WATER '
SEWER
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 gr. ting • a permit does not presume
to give authority to violate or cancel the provisions of any other state or I•'I la regulating construction or -the
performa of construction.
DAT
SIGNATUR
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health/_' / Sc
2
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CQt*1DITIONS:
Atriganio ISI -"!1 k -27I
i-22-1
OFFICIALR/ZQ
APPROVED FOR ISSUANCE
DATE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $'
S"
PERMIT NUMBER
So— #77
DATE 1—'22-80
02*
*238.00
*238.00 N
*238.00N
*O.0O
416&
*01-23—'80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0
1.14.;2 3'. ' 8''0' `4 7:7 5 I* 2 3.8, .0 'O a -r2
• N -
7!' -LA/,. -d 1/ /,5d 7' / -. L3..5-0 ;2,
r f'
.._ Zl'�'.• ;,• per=>r