1980, 04-30 Permit: 80-4128 ResidencePLAN NUMBER
6 7
APPLICATION/PERMIT
SPOKANE COUNTY — BUiLDINa CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
S �Z MI Q LEGAL DESCRIPTION - SEE ATTACHED
LOTK B ON PARCEL NUMBER/S
_ _ . _ _ _ ._ . - � I Z05d,"3 - 18`20
OWNER
3. F'3'> . I
ADDRESS
P (o . tea,
PHONE
ZIP Actual Set Backs in Feet
IP
"l-"IZ.k<{ North i South ral East SS'
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
Fire Marshall
I `K (3C�i
SIN4L� FAwAiL
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
A iyi
I
PlansExaminer
Dyes ❑No ❑ Req'd.
DESIGNER
PHONEluation
SERA Checklist
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor Upper Floors
Garage Area
Storage
l Soo I
G
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
1416 U N
TYPENo.
NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
Baths
-2
No. Stories
No Rooms
q
No. of Dwellings
7 OF -1 OTHER
,S
Z
K BLD. 1:1PLMB. 1-1 MECH. ElM.H. El POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK it
of EXEMPTION
I
V
DESCRIBE WORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8• S - S iD -
4 VALUATION
SOURCE
GAS
ELECTRIC
WATE
SEWER
Ownership
USE CODE
00
9. eo�
OF
UTILITIES
W,
tC
�/
Public ❑ Private I�0
.P.
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions i]dd
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governBuilding�type
of work will be complied with whether specified herein or not. The granting of a permit does not pto
give authority to violate or cancel the provisions of any other state or local law regulating construction
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
Mech.
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALSI
NAME DATE
SPECIAL CONDITIONS:
(\ D
Plan Check
Planning
Fire Marshall
Co. Engine
Utilities
PlansExaminer
SERA Checklist
Bui i Technician
PERMIT IS NONTRANSFERABLE
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
50 -412-S
02* *325.00
*32500
*32500
E *0.00 U
41272
04-3C'-80
6479.
TOTAL $3ZJ,Qi
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0`4. '150-i30 41?:8z
��� $�' .. , `„/''�� \ i s•i „ y; `.:hip
14
tl
<i - fi, y, . ..+� (� /tel �•' ,
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