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1980, 11-18 Permit: 80B-3924 MHPLAN NUMBER _ "S t = 4'7/ t/to 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 1. 2. 3 4. 408 ADDRESS N •30� MGbokAL•o LOT BLOCK SUBPfrv a-rt� coo OPcc+ s 7-12S DW10 M - er5�p�ti c "22 - PHONE LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S D 3 /�I 300 .2_01.7 17 ►'ma 150c. of tJ, 3o� ��d OI LC�r„,.6.2,10 cr rl' vJ. 5 ADDg ESS I560P, ICH CONER/WGj PHONE Actual Set Backs In Feet North 0 'South ADDRESS ZIP Size of Parcel Occupancy Type Const. East IWest3° Zonssification Sprinklered Oyes ❑No ❑ Req'd. 5. DESIGNER PHONE Valuation Builtling re In Sq. Ft. 06.4-0 ; aswl �• I v ADDRESS ZIP Main Floor Upper Floors 1 Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfln. Basement TYPE 7. OF WORK rkl NEW - 0 BLD. ❑ ALT. ❑ PLMB. O AD N. O MECH. DESCRIBE WORK . �. 8. H c?151 L- VALUAil'I ON g IA 00.0 SOURCE OF UTILITIES GAS ❑,/g PL. 0 MVE. IfG M.H. 0 POOL ELECTRIC 0 OTHER ATER SEWER'// W No. Baths No. Stories No. Rooms 1No. of wellings CERTIFICATE of EXEMPTION Enum. Dist. Ownership —/ Public ❑ Private (2 Location (Area) USE CODE Req'd. I hered .certify that 1 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 /! —/'f )9°SIGNATURE OF APPLICANTL SPECIAL APPROVALS NAME DATE Env. Health n/ 2 7003 Planning / Fire Marshall •Co. Engineer Utilities Plans Examiner SEPA Checklist Bull g e Iclan SPECIAL CONDITIONS: MAI. To ova N eia, d�Jo or 4,74 'J is eNt ILL LJl 1,115; UL O�yp 4w rwski 15617. rvtavt PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE Rec'tl" Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home 10 0 Other (Specify) /) TOTAL $ 19 ! •'" PERMIT NUMBER ' So 43 — 3i%`-- 02* *7'400 *7400 *7400 ,A *0.00 S 37238 11-14-80 2 6479. Q7* *10Q0Q * 100.00 17) * 100000 A *000 37242 11-14-80 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE ISSUED PERMIT NO. TOTAL Y9Z,111-;i0A00,1.2 •1 kiret Ice' or 50t.}44 ort\101621-14 •oc)4 -rH erxr" r it_scv.Th 0 r • I • -(9 • 1,1 4