1980, 06-18 Permit: 80-5923 Siding, Soffit, FasciaPLAN 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
1.
2.
3.
E.gsai
OT SUBDIVISION
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
ADDRESS
s 0.vn�
5c r iVney-
PHONE
qz&-2886
PARCEL NUMBER/S
ZIP
`N2011
Actual Set Backs in Feet
North • (South
East
(West
CONTRACTOR R 1
4 N\cVc & ^ W n* V en CO vo c-ite -
ADDRESS
N aI o - (0 awgov1\11e_ cPcA
DESIGNER
5.
PHONE
9Z8
Size of Parcel
Zone Classification
PHONE
Type Const.
Valuation
Occupancy
Sprinklered
DYes DNo 0 Req'd.- '
Building Area In Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unf in. Basement
TYPE
7. OF
WORK
0 NEW
❑ BLD.
O ALT.
❑ PLMB.
O AD N.
❑ MECH:
❑ RPL.
O M.H.
O MVE.
O POOL
&OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8.
DESCRIBE
//WORK
�� !�C/�•/I•
SOU0 /INR ;4101r 2 f71- /- I
O AS ELECTRIC
UTILITIES
9 VALUATION..Ms
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership
Public 0 Private 0
USE CODE
I hereby certify that 1 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 SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Udine ec nK�
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERAB
PERMIT EXPIRES ONE YEAR FROM DATE OFTSSUANCE
FEES COLLECTED
Single $ '/''//
ui in xf4•�
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ S'4.OD
PERMIT NUMBER
02.*. r *44,00
*4400 th-
*440015
B *G00
59238-
06=1`8-80
R16479..
•
it
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
r e S ,I
O,�ir,.118: �18i'0
DATE ISSUED •
5'92„42
PERMIT NO.
CI.11002.P
TOTAL