1980, 09-03 Permit: 80-9550 ResidenceFMIM lmwlvlm`"' ' APPLICATION/ PERMIT
9/3 & SPOKANE COUNTY - BUILDING CODES DEPARTMENT 80 �?LS'Sd
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
UB I ON
PARCEL NUMBER/S
2. Z
IU�s�E2
CoC C, s�i9iA /���� Ticy1/
/l955'/-3902
OWNER
C0114-57-A.-C4C
PHONE
90-z-elog�
3. 6u.
ADDRESS
ZIP
Actual Set Backs in Feet
C. /Z7Z./
S C,/E
!.qz/C
North /J` South G/% East West Z�
CONTRACTOR PHONE Size of Parcel Zone Classification
S rylE /Y S iv E ji9r�7 c
4. ADDRESS ZIP Type Const. I Occupancy Sprinklered
5"%,W❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Val ation Building Area in Sq. Ft.
5. 35 Hoa cj'3
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement I Unfin. Basement
6. 8r --- 93j;:�
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑OTHER Req'd. Recd. Not F3eq'd.
WORK I/BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑POOL CERTIFICATE 1
of EXEMPTION
DESCRIBE WORK Enum. Dist. 11 Location (Area) FEES COLLECTED
VALU TION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
�SgbO
UTI WATER
�j���L 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 inances governing this Building �`f"ZI CSO
type of work will be complied with whether specified herein or not. The granting of pe mit does not presume
to give authority to violate or cancel the provisions of any other state or local law reg lati g con r ction or the
performance of construction. SEE
REVERSE
) SIDE FOR REQUIRED INSPECTIONS Plumbing
MATC hC A D D I Ir`ATIrINI / / J U� CI!_MATI IRC f1F ADDI f�T l� Mach.
SPECIAL APPROVALS :
NAME DATE
Env al
Dlanning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
IAL CONDITIONS:
G
:chmcian PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
_ C
Mobile Home L
L
Other (Specify)
TOTAL $z%9, �
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09 I�.31 �11'0 955,0° x219.00
DATE ISSUED PERMIT NO. TOTAL
a
of
V
21 'o
I