1980, 10-21 Permit: 80B-2338 DamperAPPLIeATION/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
1.
2.
3.
JOB ADDRESS
L /2/A3
LOT BLOCK
,/Yaxwe //
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION
PARCEL NUMBER/S
OWNER
ADDRESS
.� /a -/.+l 3 ..-% +
CONTRACTOR
4. 416/V 4„4- /• f/y heal`
ADDRESS /
/A --C74.
("4 -'6?
/Et /a 7/0
PHONE
day-3y>v
ZIP
9'9au G
Actual Set Backs in Feet
North 'South
East
'West
DESIGNER
r 54e c %
5/cA0-- r C✓Gc
PHONE
?it -olicief
Size of Parcel
Zone Classification
ZIP
J /
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
PHONE
Valuation
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
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. -Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8./s5%a// /
VALUATION
9.
+/L /--
/fie /pit
a s i/4—t
Enum. Dist.
Location (Area)
5O RCE
OF
UTILITIES
GAS I ELECTRIC
WATER
SEWER
Ownership
Public ❑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 regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION Jo "/5—Y(/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
co
Eng i nee
UtI l it ies
Plans Examiner
SEPA Checklis
SPECIAL CONDITIONS:
!O fey:: rt
fete,-
PERMIT
cr,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
&4AT *t YOU
Plan eheck
SEPA
Mobile Home
Other (Specify)
TOTAL $ 7r cil
PERMIT NUMBER
726z33E
04* *7.00
*7.00 ro
*7.006
A *Q00 8
2337
10-21-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
130-12 810t
DATE ISSUED
213.3.8 z *Z0:o
PERMIT NO. TOTAL
>-
O
J