1980, 05-28 Permit: 80-5058 ResidencePLAN NUMBER
/Z— 7/Z
APPLICATION/PERMIT
SPOKANE COUNTY —BUIL ING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3•COPIES
JOB ADDRESS--
1. %%�1�i5 f1e
LOT. BLOCK SUBDIVISION
2 1 1 GL—PIS—e—. QOhattYd' Loc
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
s. 1 Car )s t IZ1/
ADDRESS
E
E. 1 a—)a.,1-
CONTRACTS
�—���_�+�i•J�
ADDRESS ��1 >
4.
PHONE
9,x--7
PARCEL NUMBER//51 ISss1 JIO3
e7.4)- rj
ZIP co
��I
ActualSe--��
t{Backs in Feet3d
Li-q I -1 ISouth— East
C�
I 'West l -
PHONE
a3. -4d$7
Size of Ptrcel
GO X Vi •
Zone Classification
ZIP
ype Const.
trnD •
Occupancy
Sprinklered
❑Yes litiNo 0 Req'd.
DESIGNER
5. ������i�x�•.4ik17,,
ADDRESS; '
PHONE
ZIP
7
Valuation
33 91A (1122
Main Floor
asx-M,
Upper Floors
Building Area Ti Sq. Ft.
17c.
'Garage Area
Storage
CHANGE OF USE FROM
6.
TO
c�Aree�aa/ of Decks
V, /LSD f
Finished Basement
Unfln. Basement
c9‘1- y_ Cato
7.
TYPE
OF
WORK
it NEW 0 ALT.
BLD., /0� PLMB.
R. rz1 CDESCRIBE ` ' 7f KW NJt ti.—IG
/ v
O AO N. 0 RPL. 0 MVE.
O MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
1
No. Stories
1
No- Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Enum. Dist.
Location (Area)
VALIfg3T ION SOURCE GAS ELECTRIC WATER SEWEL2Ownership USE CODE
9 21 • SCO of 64T—y}'"��
"'" 1 UTILITIES
I hereby certify that I have read and examined this application and have read the "NOTICE" prodisions 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 co ; ruction or the
performance of construction. SEE REERSE SIDE FOR REQUIRED INSPECTIONS
Public 0 Private
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env
n ng
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Check l is
Bull_ ng .chmclan
"APPROACH PERMIT REQUIRED"
Contact County Engineer's Office
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building aV.2. Jt)
Plumbing •
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$t .00
PERMII NUMBERa
so SEC
02* *21000
*21000 N
*210.006
E *000
4638
.0510!-.80
z 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
b. ; i21i?3i r1;810
DATE ISSUED
5015.85 *21O.00.°H
PERMIT NO. TOTAL
L.2j
1
•4,
1 4.....--- 2 --) —)0
. . 1
. •
, •
• • • '
**N.,
0
Btode_.-..1141
(t,
„.
f`n r.9,t)e,
.
234
- #
t.;
90
CY1/4—.) .11&