1980, 07-22 Permit: 80-7457 AdditionPLAN NUMBER
,
CO,
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. .3OS 5cO. l.t('A*
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2. 1
BLOCK
SUBDI VISIgV k
frcit2FicoIJ
3.
4.
OWNER
W 1'7)0 �Kfi,a
ADDRESS
30ej SO_ L,
CONTPArTOR
ADDRESS
ro- %61 -2 -
PARCEL NUMBER/S 2 6i{ — It Ci
ZIP
?7 -Ica
Actual Set Backs In Feet
North -2 l% 'South
East 3 'West6
ZIP
Size Of Parcel
96s"?‘.13S
Occupancy
Type Const.
Zone Classification
s1 L6i ILS
Sprinklered
Dyes DNo 0 Reg'd.
5.
DESIGNER
PHONE
ADDRESS
ZIP
Valuation
lll og
Main o
la70
Building Area ig_ Ft.
Upper Floors
Garage Area
. Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑NEW 0 ALT.
E/BLD. 0 PLMB.
lE AD N.
0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Fjpq'd.
DESCRIBE WORK
8.
VALUATION
9.
o Acn9 rriC41 07x 3 7
SOURCE GAS ELECTRIC WATER
OF itrtir-
UTILITIES
Enum. Dist. •
Location (Area)
SEWER
(IG
Ownership cei USE CODE
Public 0 Private
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 o,the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPE
DATE OF APPLICATION
ro
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env: Health
Plannin
Fire Marshall
Co. Enginee
Utilities
Plans Examine
SEPA
eckl Ist
SPECIAL CONDITIONS
RAIL -ib ov40602
/ 1 dM i •%ett i- c e 0
1- s -g ,a�ro
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building V`P' •
Plumbing
Mech.
Plan Check
SEPA
Mobile Home '
Other (Specify)
TOTAL $ 121Z
rRMIT NUMBER(
80- 7'/S7
02.*
*12200 '
* 12200
* 122006
*0.00
7,430B
07-21-80
'2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE, -
THIS BECOMES A PERMIT.
217,180
7,181,'Q'
DATE ISSUED'
74'5.7`5 *122002p
PERMIT NO. TOTAL
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