1980, 06-24 Permit: 80-6217 ACPLAN 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
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK ISUBuivibiuvjPARCEL NUMBER/S
2.
OWNER P
3.'G
ADD
ZIB,
Actual Set Backs in Feet
North South East
West
CONTRAC R r
PHONE
Size of Parcel Zone Classification
k- 1
4.
ADDRESS -
ZIP, ,
L�f
Type Const.
Occupancy
Sprinklered
-]No
%�`✓
Dyes ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
s.
Baths
No. Stories
No. Rooms
No. of Dwellings
TYPENo.
❑ NEW ❑ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
7
❑BLD. ❑ PLMB. �MECH. [IM.H.
❑POOL ❑OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE W RK
r
/
�.
Enum. Dist.
Location (Area)
FEES COLLECTED
8. ��L ' 1=l/L
i
VALUATION
SOURCEGAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
I UTILOITIES
-
Public ❑Private ❑
Single $
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
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
Mech.
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
SPECIAL CONDITIONS:
NAME DATE
1
TZ
Plan Check
Env. Health
_//} 1/
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
/�/;
f
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN TH
SEPA Checklist
THIS BECOMES A PERMIT.
�6' `2 V`� 0
w ingT_e ian
PERMIT IS NONTRANSFERABLE
PERMIT NUMBER
04 * *7.00
` i � CO
*7.00
B *0.00 10,
621.62
06-24-80
2 6479.
3 SPACE,
621,7.6 *7.00 _