1980, 09-02 Permit: 80-9446 ResidenceN NUMBER / APPLICATION/PERMIT
`�j�� SPOKANE COUNTY — WILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
11,./ APPLICANT:
COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
1. N. 5416 Ma hew
LOT
BLOCK
PARCEL NUMBER/SSV,+?,O',?FS,6-47,70'O,0=W,/,SI?
2 2C
ISUBDIVISION
I –
rR-,*CT /aS axe, w, /,0 FdR RDAO
OWNER
PHONE
44 4� ,4 4 — e9l 07
Larry Pepl inski
928-6090
RACTS �"�qT `t
3
ADDRESS
ZIP
Actual Set Backs in Feet
P.o. Box 14410
Spokane, Wn.
North South
East West
CONTRACTOR
—93214
PHONE
Size of Parcel
Zone Classification
Same
80xl37
I Single family
4. ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Same
frame
s i na l e
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq.'Ft.
32,500
1016-C
5'
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
X I
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
—
1
._►
TYPE �(
No. Baths
No. Stories
No. Rooms
No. of Dwellings
L'? NEW 11ALT.
11AD'N. 11 RPL. ElMVE.
I
j
J
7
❑ OTHER
El BLD. ❑ PLMB.
El MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8.
VALUATI N SOURCE GAS ELECTRIC WATER SEWER Ownership USE jude
9. UTILOITIES Septic Public ❑ Private Single $ 206'00
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions inc
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governinBuilding
type of work will be complied with whether specified herein or not. The granting of a permit does not pr
to give authority to violate or cancel the provisions of any other state or local law regulating construction
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION 8/23/80 SIGNATURE OF APPLICA Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env �lth
I/__y SEPA
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
B ng T cian`
Plans on file ,#R-780
PERMIT IS NONTRANSFERABLE
Mobile Home
Other (Specify)
PERMIT NUMBER
i go � 4 � dl:�� I
uc* *c_ AUG
+?r
c_ „+ O
09, 2P -?0
6.479,
TOTAL $ 206.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1;9:--02 -80 944,5' *206,0021-'-
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