1980, 10-10 Permit: 80B-1825 RemodelPLAN NUMBER_
APPLICATION/PERMIT
tot (0/80 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
2.
1.
L21118L0LCCZAS
•
Kl�B
S DIVISION
LEGAL DESCRIPTION —SEE ATTACHED
r74 1 �pee A Q
ADDRESS
77, / 2/140.:3 or40-e_d i i,/ '-44444c.-
�t.PTRACTOR
Q. , A4p RESSS
PHONE
9zz-9oz�
ZIP
q 9.410
PARCEL NUMBER/S/?3412"Q
.60 aye."
1C.VaOl
V-- axe. wdPDnenir
Actual Set Backs in Feet
North 47.
L I South 76 East(a�
(West
PHONE
ZIP
Size of Parcel I Zone Classificatione1 ,ia t
aticatizi
Occupancy
❑Yes DNo 0 Req'd.
Type Const.
5.
DESIGNER
PHONE .
ADDRESS
•
ZIP
Valuation 00 Building Area in Sq. Ft.
506O-
Storage
06O-
Storage
Main Floor
Upper Floors ` Garage Area
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
OF
WORK
NEW
0 BLD.
0 PLMB.
0 AD N. 0 RPL. 0 MVE.
0 MECH. 0 M.H. 0 POOL
DESCRIBEtIORK
S. R69'o,O&c - f es4:2Eiucc
V LUATIO
6 ab -0
SOURCE
OF -
UTILITIES
GAS
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION '
Req'd.
Rec'd.
Notl Req'd.
]
Enum. Dist. I Location (Area)
ELECTRIC
WATER
SEWER
Ownership
Public 0 Private &i
USE CODE
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 of construction. SEEt,REVERSE SIDE FOR REQUIRED INSPECTIONS/
DATE OF APPLICATION /G '-/Y D SIGNATURE OF APPLICANT /✓ rett �/J�71KL
SPECIAL APPROVALS
NAME DATE
Env.It .
Planning
v
/yr
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
'f)M Po Si/Mcn i -r- �� Btu
SEPA Checklist
Building Tech ician
SPECIAL CONDITIONS:
`Cal-eL.XAic 'At .:368'
td
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single • 7 $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER ��
Sora -' t8
02* *5Q00
*?50.0,0 I
.*150.0,06
Q00 8
1822
,1 0'=,1 '0
2 6,479.
Yt
4;1
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
710:,1081:01
DATE ISSUED
18,2,55
PERMIT NO.
'5 0:0 0'2 i' -
TOTAL
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