1980, 12-18 Permit: 80B-4997 ResidencePLAN NUMBER
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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
t.LO E, 1811i�xvect
T
2. 3
LEGAL DESCRIPTION - SEE ATTACHED
BLOCK SUB D SIO
44LtiLE1't AOoITIOrV
3.
4.
OWNER
i4o1-.c. CON3StR LA c r roti
ADDRESS
1Z772—\ • S1P12.K1G(.kG
CONTRACTOR
Same
ADDRESS
Sari if
PHONE
azz-4aB�
ZIP
ofgZ.ice.
PARCEL NUMBER/S
Actual Set Backs in Feet
North " 'South—Z.5'1 East 11101 'West for
PHONE
Size of Parcel
:c44 X 1'5
Zone Classification
SI r acsLE Fa4141CH
ZIP
Type Const.
210
Occupancy
12-3
Sprinklered
Oyes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation
5Ft t44
Building Area in Sq. Ft.
4180,
ADDRESS
ZIP
Main Floor
Roo
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
80
Finished Basement
Unfin- Basement
84,4
I�J/NEW 0 ALT. 0 AD N. 0 RPL.
BQ BLD. ❑ PLMB. 0 MECH. 0 M.H.
-d
❑ MVE.
❑ POOL
0 OTHER
No. Baths
91
No. Stories
1
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
• Recd.
Not Req'd.
DESCRIBE WORK
8. SINae
VALUATION
34r 144 -
FA, icy
SOURCE GAS
OF
UTILITIES
Its -5 ioteue b ecic Air Acee-0
ELECTRIC.
WATER
' SEWER
Enum. Dist.
Location (Area)
Ownership USE CODE
Public 0 Private
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.sSEE REVERSE FOR REQUIRED INSPECTIONS
' DATE OF APPLICATION -t +:1'- I "\--- rSIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Enea h
Planning
deo /2//6
- Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technician
SPECIAL CONDITIONS:
-1 csarvS e.. F'ttE
"APPROACH PERMIT 14EQ RPF)»
Contact County £ng ,' ;„mice
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building *215r00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 21 S
PERMIT NUMBER
02* *2150.0
* 2150,0
* 215006
A *00,0 8
48681
1 2'� 1 6L 8,0
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
112�:w!1 4&'18;b'
DATE ISSUED
9.:7"g,*21'M
PERMIT NO. TOTAL
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