1980, 12-12 Permit: 80B-4799 GaragePLAN NUMBER._ _ 1
2-.269/ Ii 21i • A/go
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
JOB ADDRESS
1.
s4z. LOT
2. Co
OWNER
a iAamc9
ADDRESS
E. `s 7c9
CONTRACTOR
4. SA)MC
ADDRESS
L • S'7e3 ►flat r/
LEGAL DESCRIPTION — SEE ATTACHED
BLOCK
A MC
SUBDIVISION
kAaacttf�l:Yon3 'To
a - A,oAms
14u,•sc.uINsod
PHONE
4-1,853
PARCEL NUMBER/5
1'a544- 1118
ZI P
M AINCICIZOC
Actual Set Sacks in Feet
North 30
PHONE
Size of Parcel
123 x ‘cc
ZIP
Type Const.
V- 4
DESIGNER
5. ADDRESS
PHONE
ZIP
Val ua$oon/)
too
Main Floor
f
South East t g West
Zone Classification
Ay. S.a c4a yv
Occupancy Sprin kleretl
�—' ❑Ves ONo 0 Req'd.
Building Area in Sq. Ft.
Upper Floors Garage Area Storage
isoa
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
L,.7/NEW 0 ALT. 0 AD'N.
Ltl BLD. 0 PLMB. 0 MECH.
❑ RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
1
No. Rooms
No. of Dwellings
I
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not R d.
DESCRIBE WORK
8. DET14C.Mctj c AR#�tic W/o Scra•.p ?RA!ATE
Aj s VALUATION
„e e c
i
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
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
iSIDE FOR REQUIRED INSPECTIONS .
DATE OF APPLICATION i"� L-V/J� l / as SIGNATURE OF APPLICANT
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER SEWER
SEPTIC
SPECIAL APPROVALS
NAME DATE
Planning
74e
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
Enum. Dist.
Ownership �/
Public 0 Private Y
Location (Area)
USE CODE
SPECIAL CONDITIONS
STfl.aser Prato R.. TO -Main tP
)2
Tory Pos-nat)RIT !)J90
SEPA Checklist
Building Technician
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
1'$10.00
Other (Specify) 5t• pZ
1fJu15TF 112 ocs
TOTAL $
,tel ..4
PERMIT NUMBER
X0(3-��9�
02*
* 11200.
* 11200
47982
1 2,-1 2-8.0
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
• 1•214`,1'2;, til
DATE ISSUED
47'9.91 4*1'1200-a.,z' -
PERMIT NO. TOTAL
0
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;{ ou,r
Prtiac46
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V1
til
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