1980, 03-11 Permit: 80-2084 ResidencePS'AABER
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
1: ?. lI IGS 1461/1, AVa
T 134C SUBDIVISION0052 �lJn VPHJjpf OKI^/
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ADDRESS 1
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3
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S // 51y— o751O
972-14'
Required Set Backs in Feet
North 30 'South
East
4.
CONTRACTOR
z/';eM Csl
PHONE
Size of Parcel
co
Z;fglassificatjon
ADDRESS
ZIP
- Type Const.
Occupancy
Sprmklered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuat7n Q
�i D
Building Area in Sq. Ft.
1300 -
ADDRESS
ZIP
OWL Area Basementrea Garage Area
1300 13a0 L1,1
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
pliteLevel
Rancher
TYPE
7. OF
WORK
0NEW ❑ ALT. 0 AD N. 0 RPL.
In BLD. 0 PLMB. 0 MECH: ❑ M.H.
tJ MVE.
0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
DESCRI WORD(
srI1t LLL IBX o COW (R)
VALUATI N Source GAS EL$l.CCcT,,RIC WlI� y4,,tE��Rrr,,�
9. Utillities ✓7 4O12jZ'V
SEW R
IG
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.
DATE
DEPT.
SPECIAL APPROVALS
-
REQ'D. REC'D.
/V l Mme, ECN t' 1. 10
SIGNATURE �
Env. Health
Planning
,4 Wico
Fire Marshall
Co. ' r
Utilities
3j11 h0
Zone Clearance
-SEPA Checklist
NOME OWNER'S WARRANTY
SPECIAL CON�DIITIIONNS: ✓V
/�' Z K�orJ
V"T` I
e I„2l fl
fnab i Nlairorl
7,7 —
YES .,DATENu 4
✓///
ICIAL
PPRO % OR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
a)
TOTAL $ .741
DATE
r
PERMIT NUMBER
8� -)'a8-f----r;
02* *800
*800
* a Q Q U
E *Q00
1'8Q84
03=05-80
2 6479.
02* -*6800
*6'800 Iru
*614006
E *Q00 8
208.32
03-11-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISECO E$ A PERMIT.
05170: 20842
*76.0.0aP'
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