1980, 01-21 Permit: 80-386 FuranceALAN 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 4 COPIES
JOB ADDRESS
h iti�cL,ti LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNERPHONE
3. « titi
ADD ESS{o ZIP Required Set Backs in Feet
C�Ci� �� JW\.&- + ALL(j,) North South East West
CONTRACTOR PHONE Size of Parcel Zone Classification
' r
4.
ADDRESS ZIP Type Const. I Occupancy Sprinklered
% ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE g NEW ElALT. ElAD'N. 1:1RPL. ❑ MVE.
7, OF El OTHER
WORK n BLD. ❑ PLMB. MECH: ❑ M. H. ❑ POOL CERTIFICATE Req'd. I Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
VALUATION Source GAS ELECTRLC WATER SEWER
of
9. utilities x is iC 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 Building
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. Plumbing
DATE 1-- 1� — S -D SIGNATUREL,-L—Lt.SL� L2��tTr
Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
nnTF1'011� 71[ JnFcirioi 1 (l��i�\��1�iY��l^
Plan Check
SEPA
Mobile Home
Other (Specify) I
PERMIT NUMBER
DATE
C1 -r1 -.C;
TOTAL $� �� C�
WHEN MACHINE VALIDATED IN THIS SPACE,
THISrCOI14 S A PERMIT.