1980, 11-04 Permit: 80B-3189 Repair RoofPLAN NUMBER
L'
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.
JOB ADDRESS
S.'!oz
/27c'/i//VNoN
LEGAL D"tSCHIPTION — SEE ATTACHED
LOT
BLOCK
z
SUBDIVISION
C4Roc./NE ,Qnoifloq'
OWNER
G6RAto
Pic CAcc um
PHONE
535-s7uz
PARCEL NUMBER/S
2353!-/Z/7
ADDRESS
5. <'oz meX/N/YO.V
CONTRACTOR
Mane Eaten, ses
ZIP
99zoG
Actual Set Backs in Feet
North (South
- East 'West
ADDRESS
C.57/2 FOIST •
N. L✓ • //t/c.
PHONE
53S 8737
Size of Parcel Zone Classification
3ne,0255 //lvcr/. fNMiG v SuB.
ZIP
992o6
Type Const.
Occupancy
Sprinklered
❑Yes 0No D Req'd.
5.
6.
DESIGNER
PHONE
Val tion
lo, .0100
Building Area in Sq. Ft.
ADDRESS
CHANGE OF USE FROM
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
OF
WORK
❑ NEW
O BLD.
❑ ALT.
❑ PLMB.
❑ ADN.' 0 RPL. 0MVE.
❑ MECH. 0 M.H. 0 POOL
OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8. /Po:me Roar avag ,E t S/1eCTRoae
Enum. Dist.
Location (Area)
J VALUATION
9. /0,000
SOURCE
OF
UTILITIES
GAS
ELECTRIC
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 construction or the
performance of.construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer.
Utilities
Plans Examiner
5 P Checklist
Building Technician
aL Cl z V
///v
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
FEES .&nseo ON C eSt° Volta, non/
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single ��$$
Building 80.00
Plumbing
Mech. -
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $Ao.010
PERMIT NUMBER
808- 3/619
02* *8Q00
*8000 bi
*8Q006
A *000 8
3188
1.1-04'-80
2 6479._.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
,1'11e.0:4.:=10; 31 &9t *'8Q0.0ai'
DATE ISSUED
PERMIT NO. TOTAL