1980, 04-09 Permit: 80-3289 Pole Bldg11111.0. -
PLAN 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
1.
2.
3.
OB ADDRESS
r
1302 Loci/ Sr
LOT BLOCK SUBDIVI ION
O NER
ON PR IGKE7%
A DRESS
Ns 1303 lacetsr
covTRACTOR
ook .s c$'r''EeL Rio61S4. AD DRESS r/ //
)6dsa ij L1.1c,R. //nee Qo
D SIGNER
5. ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
`TarPCS y
ZIP
99ao
PHONE
7�3�49
PHONE
ZIP
CHANGE OF USE FROM
6.
TO
PARCEL NUMBER/S / 15-9f .2 - 0707
op.p •BSS��(,1 -s`!'o�'f. 0f' G. 360' /U Ya
Required SetmBack in FeetLt�J i i /
North I D !South "T 0 East iOQ 'West 4/mL.
Zone Classification
Type Const. Sprinkleretl
Tole OYes ONo 0 Req'tl.
V atIon Building Area in Sq. Ft.
' 4408- -s '` l IS'a
DWL Area I Basement Area Garage Area
Storage
Asa,Rancher
Size ofj'arcel f'
90 X 3/to0
Split Entry
Occupancy
Split Level
TYPE
7. OF
WORK
LTNW - 0 -ALT. 0 AD N. 0 RPL. - 0 MVE.
ICV0 LDNE: 0 PLMB. 0 MECH: 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
CERTIFICATE
of EXEMPTION
I
. No. Rooms
Rec. Room
Req'd.
Rec'd.
Not Req.d.
8.
V`—)0/E type
St tL Sfr (zv' 5 v ,)//ELEC//IC
ALUATIO,O
utilities
s, (�OOBOp`
DESCRIBE WORK
ATER 11/ 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 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 o�fy construction. y� /� ,y/)
DATE V-?-- D
SIGNATURE CT' ✓+�A'i •
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health ��I/n/
Planning [%'/T///_L( y
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE a//9/eo OFFICIAL
APPROVE
/I5 ,
C ISSUANCE
FEES COLLECTED
Single $
Building /S0. 00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 30.00
PERMIT NUMBER
3z 89
DATE
'02* *5Q00
*50.00 t3
'*50006
E *Q00 E
32884
04=09-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A I• RMIT.
014;:''0' 'a80' 32.8.92 *5.0.00 2.0
t
PA
•
.817
0