1980, 7-10 Permit: 80-6913 DampersPLAN 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. FAST/09Q9 MAY "(41
LOT BLOCK SUBDI SION
2.
OWNER
3 ACi< w0073 auy
ADDRESS
6 -ST /090y MAI<ttJCLI-
C ONTRACTOR
4. /aiM.QLir
Y gA70v6
ADDRESS
6isr /2710 /ivDi
4:A/A-
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
PHONE,
73`iy
2'3y 106
Actual Set Backs in Feet
North 'South
East 'West
PHONE
q2e-210b
992'6.
Size of Parcel Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
ADDRESS
PHONE
Valuation I Building Area In Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfit -h. Basement
TYPE
7. OF
WORK
ID NEW
0 BLD.
ID ALT. ❑/AD N. 0 RPL.
❑ PLMB. )Q MECH. 0 M.H.
0 MVE.
0 OTHER
0 POOL
DESCRIBE WORK
B. /usr4LL d „Auo y.,, t=�. v ` S
VALUATION
9.
SOURCE
OF
UTILITIES
ELECTRIC i WATER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private 0
USE CODE
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 egulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIOJ11
DATE OF APPLICATION Iiiiiii_SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Check!
B
OAR' A
ea,e,)
FOR GAS APPLIANCES
PIPE ST7_ES
PIPE LENGTHS
BTUS
•
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
700
04* *7.00
*7.00 N
*7.006
*000 0
691.28
07-10-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6 9'L 3`s'
*7,0.0
DATE ISSUED PERMIT NO. TOTAL