1980, 09-08 Permit: 80-9785 MHrl FLAN NUM[itK ,
APPLICATION/ PERMIT
—1 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. /V VV01 J -0,-L AD LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK SUBDIVISION P ELNUMBER/S
2. ® � %� ' %`yam >C� / / � '
0 r/4 s�� ��S',�,2 —O IUB
OWNER PHONE �® 7✓/0
w �
3. �' O/,lam
ADDRESS / /1 ^� ZIP r'7ry Actual Set Backs in Feet
259,01 V� a►d Vy. North South L East 310 West ;S
CONT CTOR PHONE ? Size of Parcel Zone Classification
111
4. ADDRESS "� ZIP Type Const. Occupancy Sprinklered
j5 J6 A4 ��, �i - ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
.� &
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Baseme
6. l4
.,_/' No. Baths o. Stories No. Rooms No. of Dwel',
TYPE k p(I NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 2 1 - �.
OF
% WORK �❑ BLD. ❑ PLMB. ❑ MECH. M.H. ❑ POOL ❑ OTHER CERTIFICATE Req'd. Recd. Not Re
of EXEMPTION
DESCPIBE WORK Enum. Dist, Location (Area)
8 lj�� �� ✓ FEES COLLECTED
VALUATIONSOURCEGAS LECTJR`IC WATER SEWER
OF Ownership USE CODE
9... JOF
Public ❑Private Single $
1 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 Building
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 Plumbing
1,
DATE OF APPLICATION SIGNATURE OF APPLICANT 'Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SEPA
Mobile Home 141)
Other (Specify)
d.
PERMIT NUMBER
0-1- 7_
G,.
02* *10000
*10000
* to -
1000061
A *0.00
97846
09-08-80
0479,
TOTAL $ '
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLEQ 91-•� 8i'"'g �i % 8 5 z k 1 �. O a -J
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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