1980, 10-09 Permit: 80B-1769 AdditionPLANN M
I 2 /029.
/ APPLICATION/PERMIT
ltd/el /So 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
• /£_GoccesT
LOT
2.
BLOC
LEGAL DESCRIPTION - SEE ATTACHED
BDIVISION
3.
OWNER
GrjE.z
!/e/EC./c6
PHONE
9zt/--oz3C
PARCELNUMBER/S8 96, /Qttor GOr2 /✓f2
OP Ger 3 au- / oPPO47c4#WtV sr/c/cr5
/7S 3 03oz_
ADDRESS
y Ce/ 8 tocctcr
ZIP
99za4
Actual Set packs in Feet
/
ay/INortf15/-/SouthSw I East %yy3 r
'West .71
4.
CONTRACTOR
Rome/t7 ,5. 6,Oescc /iXX.
PHONE
535-88'27
Size of Parcel /
/-2-2, x3i/ AP?
Zone Classification
464/Cat>uegL
ADDRESS
o. Box ao8c
ZIP
C79ZOZ
Type Const.
V -N
Occupancy
tZ
Sprinklered
❑Yes No 0 Req'd:
5.
DESIGNER
PHONE
ADDRESS
ZIP
Val tion
q` oo •
Main /Floor -
41cxD
Building Area in Sq. Ft.
4/00
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
Mr NEW
0 BLD.
❑ ALT.
❑ PLMB.
Ie AD N. 0 RPL. 0 MVE.
0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. /Rooms
No. of Dwellings
•
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
V
DESCRIBE WORK
8. /94,0/7ioi0 '76
4 VALUATION
Enum. Dist.'
R6•si0 c..wr
Location (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER •
SEWER
Ownership 54 USE CODE
Public 0 Private
I hereby certify that 1 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 INSPECTIONa
DATE OF APPLICATION 7 —c2- I-FVaSIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. H
Plannln
£&cc.®v//29
Fire Marshall
Co. Engineer
Utilities
Plans Examiner /Q
TOM PGS7L$W►1ir fZ&
SEPA Checklist
Bu' ding Tech icia T -yp--
4I Q4.// �andLdJ
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
4
TOTAL $ ACIC9'C)
PERMIT NUMBER
'02* *80.00
*80.00 bi
*�80.0.0�
A *Q00 8
1768
.1 0: 0 9- 8,0
2 6.47 9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE'ISSUED
1'r769�1 e;80.'00,2 -
PERMIT NO. TOTAL
>-
0-
0 O
W
LI-
WHEN
l