1980, 06-30 Permit: 80-6463 Demo BldgPLAN 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
JOB ADDRESS
5. 7645 ' eiV eAlogivorl
LOT BLOCK SUBDIVISION
2
OWNER
/V/tn )r,e&,otsg#cx
PHONE
53 S'/$s9
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/3
9 845
C4ko4491S Nye Ere /V to'
2353%- /S/z8
ADDRESS
St- los- r2rcrr,n,won,
ZIP
99a e
Actual Set Backs in Feet
North (South
ast 'West
4.
CONTRACTOR
Sfrrr/c
PHONE
Size of Parcel
Zone Classification
ADDRESS
Sae)/E
ZIP
Type Const.
Occupancy
Sprinklered
Dyes DNo 0 Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basemen
Unfln. Basement
TYPE 0 NEW
7, OF
WORK 0 BLD.
O ALT.
❑ PLM B.
❑ AD N.
O MECH.
O RPL.
O M.H.
❑ MVE.
❑ POOL
E OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd
Recd
Not Req'd.
8.
DESCRIBE WORK
O dr/ Q
R
LUATI ON
9. /CO.CO
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
a)C.t
SEWER
Enum. Dist.
Location (Area)
Ownership
Public D Private
USE CODE
1 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 INSPECTIONS
SIGNATURE OF APPLICANT')
DATE OF APPLICATIONJi, —09 7– P-0
SPECIAL APPROVALS
NAME DATE
Env_ Health
Planning
Fire Marshall
Co. Engineer
UM! t le5
Plans Examiner
SEPA Checklls
Bull g chnlcia
SPECIAL CONDITIONS:
gfr
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specif,����///,'�1 L °' Am:5
TOTAL
$ /0. oo
PERMIT NUMBER
80-'P/6.s
02* *10.00
* 1000
* 10006
B
*000 8
64628
06-3.0-80
! 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
64'6.3= *10.0.0:2F!, -
PERMIT NO. TOTAL