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1980, 07-24 Permit: 80-7587 MHPLAN NUMBER ?/1,4ifo 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 //�.�/ I�� S. i` 2•3 LOT BUCK SUBDIVISION, ' ry I� Avortin., LEGAL DESCRIPTION - OW;1I%c LI r\1 ..J"I rIV`N1�1 ADDRESS o I G(C11�J I�1ON I) W 4/ CONTRACTOR P'I �) PHONE PARCEL NUMBER/S Z3 Lo-rG I.LocK 5 -XG. Actual Set Backs in Feet North r7 South QS 4-1 PERMIT NUMBER g -15-g 7 SEE ATTACHED '0174 - I 137-4,<4/V133 East ❑Yes ( (West Size Zo(te C arcel lassificatin 6 x97 & RIC- - ADDRESS ZIP Type Const:• Occupancy 5. DESIGNER PHONE At Valuion -P. ADDRESS ZIP Main Floor Sprin Iered ❑No 0 Req'd. Building Area In Sq. Ft. 2q -y48 Garage Upper Floors Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK VNEW 0 ALT. 0 AD N. 0 BLD. 0 PLMB. 0 MECH. ❑RPL. VM. M. H. ❑ MVE., 0 OTHER ❑ POOL No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Recd. Not Req'd. 8. DESCRIBE WORK q� Mos Lr - 0115. 9167. oozi SOURCE OF UTILITIES 241)(1.48 Enum. Dist. Location (Area) G ELECTRIC WATER SEWER c Io Ownership J/ 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 td give authority to violate or cancel the provisions of any other state or local law regulating constructio Q the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS DATE OF APPLICATION SPECIAL APPROVALS NAME DATE Hoa h PI nni g • r all Co. Engineer Utilities Plans Examiner SEPA Checklist SIGNATURE OF APPLICANT SPECIAL CONDITIONS: 1' krnc F1404,10 iN e fr}°!at cf wi v110114 to Pn DtJ3, kJIor ONX AtAAAino 1814810 /fAAR. 73 ocJ,refl N10 coHO('t"IoNS PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA 4\00, on Mobile Home Other (Specify) TOTAL $ tie.C'i * 1 op 00 * 10000 * 100006 E *000 8 6972 07-.1.11,180 2 6479 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 0,7,4,2141,781'0' 758.7=, *1'0'0,00,,°r2 DATE ISSUED PERMIT NO. TOTAL ■ ■n■■■■ ■■ ■■ ■ ■ ■ ■■■■■ ■ ■ ■ ■ ■N ■■■ ■■ - ■ ■■ ■fl ■■■ o�LeO�■ ( x i-) , -IP ■ _ ■ ■■■■ - :