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1980, 06-11 Permit: 80-5660 ResidencePLAN NUMBER /0— APPLICATION/ PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DESCRIBgW_ORK � 8. '� � L&`IJ� VVALUATIONN> Source GAS to /' f WATE(R� f SEWER L / �- of Ly JN it / 7 7r L' / Utilities '�� 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 stateorlo al law regulating constructi or the performance of construction. � �j�`� DATE SIGNATURE, ' SPECIAL APPROVALS SPECIAL' ONDITIO S: DEPT. REQ'D. RECD. �3 r —KI J C2�i'G—?4-7 l ) Env. Health Planning Fire Marshall C i r Utilities �O Zone Clearance SEPA Checklist -TLA+J� b nnTl= 'v- In()FFirini FEES COLLECTED Single $ Building©� r Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL DATE PERMIT NUMBER bo- � e of WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS S, Vli LEGAL DESCRIPTION — SEE ATTACHED BLOCK SUBDIVISION n PARCEL NUMBER/S ;.rh jo 2. WNER . z Lt PHONE , jI 3. ,C �t. ,� ADDR S��>�9 d �+L�!�c"70 •a/ ZAP in �' 7 �i` Southeet NorthRequiredSetBacks East West CONT ACTOR PHONE �z `� �� d,> r�' Size of Parcel s3"1� Zone Classification 4. .- 4 :; : u t r ti i 3 X 3 'type ADDRESS. ZIPS ✓ / wr1G��y Const. Occupancy Sprinklere l a 6�= l 't rs�9c3-is - ❑Yes 914o ❑ Req'd. DESIGNER~ PHONE Valu ionea5� Building Area in Sq. Ft. ADDRESS ZIP OWL Area Basement Area Garage Area Storage CHANGE OF USE FROM_,... TO Split Entry Split Level Rancher 6. 1 X I - TYPE A NEW ❑ALT. ❑ AD -N. 1-1RPL. ❑ MVE. No..Baths No. Floors No. oms Rec. Room ""—" 7, OF ❑ OTHER WORK XBLD. ❑ PLMB. ❑ MECH: ❑ M.H. El CERTIFICATE Req'd. I Recd. Not R d. of EXEMPTION DESCRIBgW_ORK � 8. '� � L&`IJ� VVALUATIONN> Source GAS to /' f WATE(R� f SEWER L / �- of Ly JN it / 7 7r L' / Utilities '�� 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 stateorlo al law regulating constructi or the performance of construction. � �j�`� DATE SIGNATURE, ' SPECIAL APPROVALS SPECIAL' ONDITIO S: DEPT. REQ'D. RECD. �3 r —KI J C2�i'G—?4-7 l ) Env. Health Planning Fire Marshall C i r Utilities �O Zone Clearance SEPA Checklist -TLA+J� b nnTl= 'v- In()FFirini FEES COLLECTED Single $ Building©� r Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL DATE PERMIT NUMBER bo- � e of WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 13.84._E C, rC "n Gur b cd -ky 93. 95 Etew. Lot P-4' B11(.1 M;cA PA,qk Add.tieN S• 1112 M;I-A Park