1980, 09-30 Permit: 80B-1122 ResidencePLAN NUMBER
R-76.9 `r Q/3ole0
Basic Plan
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. 1LO LO1/ PC/D
CK
2. '7 /
Coe -
Su:.I IppON .y --
LEGAL DESCRIPTION - SEE ATTACHED
OWNER.
3. ,�(/
PHONE
922-407
PARCEL NUMBER/S
LOT 7 JC3LK/ .
HOLETr5 R b.DiridAl
ADDRESS
/i 7.Q/ �. Clttt:�ln�2
• COR
4. ADDRESS
ZIP
99.21G
Actual Set Backs in Feet
North (South
East 'West
PHONE
Size of Parcel
ZIP
7 D,USD
ype Const.
Zo a Ctassif'cation
f L
Occupancy
ISprinklered
Dyes DNo 0 Redid.
5' ADDRESS •
DESIGNER
PHONE
ZIP
Valuation 40 Building Area in9q. Ft.
'33 c 00
MaiX Floor
S>4itI
Upper Floors Garage Area
Storage
CHANC: OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
RBS//.
TYPE rotjeJ NEW
7. OF
WORK ❑ BLD.
DESCRIBE WORK
8.
g�VALVA ION
3.9,-SD e
❑ ALT.
❑ PLMB.
O AD N. D RPL. D MVE.
O MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
4
No. Of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
NotyReq'd.
�'44I4& �..t
OF
SOURCE II GAS ELECTRIC
UTILITIES
Enum. Dist.
Location (Area)
WATER
SEWER
Ownership •
Public 0 Private (�
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.�iSEE REVERSE SIDE FOR REQUIRED INSPECTIONS ,
DATE OF APPLICATION /1.--2:a"--ger, —ger, SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
EnvIJ-eal
f�D 1/46
Planning vE
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Zing Tec Iciaryj
SPECIAL CONDITIONS:
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
tel Pt R'MIT NUMBER
SoT3- 1t-zz
02* *21000
2,10.100 m
*210008
A *GOO 0
91.8E
09=26-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'9143;:0:! .8101
11222 t'' 21a,01)a�
DATE ISSUED PERMIT NO. TOTAL
I.
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