1980, 10-06 Permit: 80B-1474 Siding, Soffit, FasciaPLAN NUMBER
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
2.
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
LO'ir BLOCK SUBDIVISION
OW�yNER
3 /-OLU 5 L • Posey
AD D R ESS
<flg s, flJ? ',na/d
C NTRACTOR
c Vay "Bro jAcrs
4' ADDRESS
Air
3/0(o Angor/1P Roo d
DESIGNER
5.
0,0
PHONE
PARCEL NUMBER/S
ge
ZIP
PHONE
9/71 ce0
Actual Set Backs in Feet
North 'South East (West
Size of Parcel 1 Zone Classification
Z49ao/
Type Const.
Occupancy
Sprinklered
❑Yes DNo 0 Req'd.
PHONE
Valuation Building 'Area in Sq. Ft.
9esD.1°
ADDRESS
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE 0 NEW'
7. OF
WORK 0 BLD.
DESCRIBE WORK
8.
O ALT.
❑ PLMB.
O AO N.
O MECH.
O RPL. 0 MVE.
❑ M.H. 0 POOL
9C'G
pp"OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
Enum. Dist.
Location (Area)
VALUATION
SOURCE G
OF
UTILITIES
EL RIC
WATER
SEWER
Ownership
Public 0 Private 0
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 constructs. or th
performance ofconstruction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
41'
DATE OF APPLICATION 1/c/�S(/A/1
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
5 Ch eckllst
Building Technic
PERMIT IS NONTRANSFERAB
PERMIT EXPIRES ONE YEAR FROM DATE 0 SSUANCE
FEES COLLECTED
S.ngle $LL�_01)
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $/fit at)
PERMIT NUMBER
gra te-/z1-
Oa* *44.00
*44.00 N
*44.008
A *0.0.0
147.32
10=06-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'Hflt6"��•'0; lif4'7.4� +;4 4Q10
DATE ISSUED PERMIT NO. TOTAL
›-
Li -
WHEN
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