1980, 12-11 Permit: 80B-4753 RemodelPLAN NUMBER
2//,'/ (0
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. E i$i0c
LOT
2. 1
OWNER
3 LcStc2
ADDRESS
E
E. )Bio6
raft A2ctna 1:::).2\Vc
LEIAL DESCRIPTION - SEE ATTACHED
BLOCK
SUBDIVISION
SN Kelt ROACI MeaBicc
PARCEL NUMBER/S
1&o rn c s
F. 4ku me
Naeem, •Lb(atue
PHONE
Ci z!o-6Qrz.
OS5Sz-0201
ZI P
X02-7
Actual Set Backs i1?c.Feet
North 'South lSil
Eat 'West
CONTRACTOR
4 SUN CRArT
ADDRESS
So/c 4 -sq
DESIGNER
5.
PHONE•
773-45z9
Size of Parcel
64 X \'301.0(4
Zone Classification
acs. T%1oa1LE
OST FACLs I t p4,1/45
ZIP
833
Type Const.
Occupancy
Sprinklered
❑Yes DNo ❑ Req'd.
PHONE
Valuatlo 1 2.00
Building Area In Sq. Ft.
154
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
154
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
E NEW
E(BLD.
D1 ALT. ❑ AD N.
0 PLMB. 0 MECH.
❑ RPL.
O M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
1
No. Rooms
No. of Dwellings
CERTIFICATE
. of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.C.OUCR ErvCLO5 >=x(Sr(wf, Dc—:.cic
Enum. Dist. (Location (Area)
1.4. VALUATION SOURCE
y:tpl(p.00 UTILOITI ES
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS �/��_ �J
DATE OF APPLICATION /a/ /( / 77)SIGNATUREOF APPLICANT/2 �2�� j 97tC..4 1iA- r
-SPECIAL APPROVALS SPECIAL CONDITIONS:
rNclosE Existac PoRc1► At4P Roar r A covsg.[v pa
"N S'TRAdcfib$I of 14/1S ffQoM FLOQ1L to EX/ST/AK. Rcpt
R., X Lhu 2 tie ''oc i " P>a'WodP s/t/i/N6. `IZ -I I
INSULAT 1o14 III srupS. bXlrnNcx FLao12_ -tf%t(w lie
. xi() I+EAPe9..7 2X(,a, 2 1 o c 2 -XL -4- Per-Jan/Cr
1,10-r„ Bic L($[,a•ks P- FMB 17Al4Lt-'LivIP* /1 -/CFA
JUST AN ENcLros&P PURc.F1'-
GAS
ELECTRIC
WATER
Comm .
SEWER
ScPric
Ownership
Public 0 Private IV
USE CODE
NAME
OATE
Env. Health.
NO -s- (Rea? D
Planning
Fire Marsha
Co. Engineer
Utilities
Plans Examiner
IoM PoSTI.F.voA1T ! 2/410
SEPA Checklist
BUIItl Irig,Technic iy r
9/1-D�er
cicenf56 oic e
olio//E/
PERMIT IS NONTRANSFERABLE
27 -
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.'
Plan Check
SEPA
Mobile Home
Other (Specify) 0 -
TOTAL $ ('OO
1I .00
02.
4'52
PERMIT NUMBER
¢'T3-47153
12-st-So
c04-14
. coo
I‘. oo
1/4.00
14
14.00
0.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12IE,'i440i
DATE ISSUED
475.31 *11:0020
PERMIT NO. TOTAL
0
W