1980, 06-02 Permit: 80-5195 Sprinkler System11
OWNS
Eg
APP
;`tTION/PERMIT
PLAN NU BER
3. GLG/V
SPOKANE COW—
_ 3UILDING CODES DEPARTMENT
ADDRESS
NORTH 811 JEFFERS,,
KANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT:
COMPLETE NUMBERED SPACES —
Plr'ESS HARD TO MAKE 4 COPIES
JOB ADDRESS
. Z
4UT14qL
LEGAL DESCRIPTION — SEE ATTACHED
LOT I
BLOCK
15 I ISION
North South
East West
PARCEL NUMBER/S
11
OWNS
Eg
3. GLG/V
/0
`-5
ADDRESS
ZIP
Required Set Backs in Feet
E J O�2EsS
�/
North South
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
fC JU
4,
ADDRES
ZIP
Type Const,
Occupancy
Sprinklered
O!
[--]yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE NEW 1-1 ALT. ❑ AD'N.
❑ RPL. 1:1 MVE.
No.
No. Baths
No. Floors
No. Rooms
Rec. Room
7, OF
El
CERTIFICATE
Req 'd.
Recd.
Not Req'd.
❑ BLD. ❑ PL MECH: ❑ M.H. ❑ POOL
WORK -MB.❑
of EXEMPTION
8. nAr
VALUATION IF Source GAS IV ELECTRIC WATER SEWER
9. utiliofties
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
performances offconstruction.
DATE, / IJV
/d- / SIGNATURE �JJI
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE4144 OFFICIAL
FEES COLLECTED
Single $
Building
Plumbin_
Mech.
Plan Check
SEPA
Mobile Home
ther (Specify)tt
t G� %�
TOTASL45' $ b, J V
WHEN MACHINE VALIDAI
THIS BECOMES A PERMIT.
PERMIT NUMBER
)J
DATE �5:14,:5 46
03* *5.50
* 6, 5) r ~
*550
F 0.0 0
51 9,4R
06-02-00
s? 6,479,
N 'CHIS SPACE,