1980, 05-13 Permit: 80-4686 ResidencePLAN 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 3 COPIES
1 Jo13 ADDRESS a� vttly 0d � � LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK BLOCK Svtt ^ PARCEL NUMBER/S.3 ���y�
2. 3, G� V I Arr 'r. �J
OWNER PHONE
12 �J , (� F��`✓ ,- v& DS
ADDRESS
CONTRACTOR I P E
4. ADDRESS P
DESIGNER PHONE
5. ADDRESS ZIP
CHANGE OF USE FROM TO
6.
.-
Actual Set Backs in Feet
'n
6�
North I'-' South 60
East West
•���
Size of Parcel
- �
Zone CI
"
ssification
jc ,'?>
BLD.
Type Const.
Occupancy
Sprinklered
Req'd.
Rec'd.
Not Re d.
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
L7
DESCRIBq WORK
Main Flo o
Upper Floors
Gp ge ea
Storage
FEES COLLECTED
Area of Decks
i
Finished Basement
Un/fiin.
Basement
No. Baths
No.
Stories
No. Rooms
No. of. Dwellings
TYPE If W
El ALT. 1-1AD'N. 1:1RPL.
ElMVE.
6�
'��-
6� -�
7, OF
11 OTHER
BLD.
❑ PLMB. ❑ MECH. ❑ M. H.
❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Re d.
WORK
of EXEMPTION
L7
DESCRIBq WORK
Enum. Dist. Location (Area)
FEES COLLECTED
r 1 M 1 U;Io;l 1 Y-1, -
—F—VAI UATION SOURCE GAS LLE IC ATER SEWER
OF �/ t�LLV l Wr Ownership USE CODE
9. UTILITIES / V �� Public 1:1 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 ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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 INSPECTIONS Plumbing
i
DATE nF APPLICATION d ?el SIGNATIIRF OF APPLICANTAG�fi1/ ,XG Mech.
SPECIAL APPROVALS
A [,L, e5l�^J NJ '3 12- C- / �-- I
(I J��u
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
PERMIT NUMBER
02* *334.00
*334.00
*334.0061
B *0.00
449.4@
05=08-80
2 6,479.
SEPA
Mobile Home 4
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
05-1`'31`-80 65,5" 3340`0`°
DATE ISSUED PERMIT NO. TOTAL