1980, 12-05 Permit: 80B-4530 Residence6
PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
W –.2,0 7�Z 1%6-/o SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH
`
/ NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOT B KBDIVISION PARCEL NUMBER/S
2. /6 Z /111/CN Y�'fo
OWNER PHONE
3. F. 0, ok2ekda". f3T09 2 e,,e—l8
ADDDRESSJ' l �i ZIP/ �/ Actual Set Backs in Feet
/` d - �X J 7 4 7L'f7 North w� South J. East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
..Sil1W
�i LE 1151/117111-1
4
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
I
❑Yes ❑No ❑ Req'd.
DESIdNER
PHONE
VOation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main'Floor Upper Floors
Garage Area
Storage
l617Z '-'
S'ze
I —
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE NEW ❑ ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
No. Baths
?—
No. Stories
i I
No. Rooms
No. of Dwellings
7, OF 11 OTHER
I'll
WORK BLD. 1-1PLMB. ElMECH. ❑ M.H. 1:1 POOL
CERTIFICATE
Req'd.
Recd.
Not�eq'd.
of EXEMPTION
DESCRIBE WORK
Enum. Dist.
Location (Area)
8.
FEES COLLECTED
J 1C,*/L f
VALUATION
I SOURCE
GAS
ELECTRIC
WATER SEWER
Ownership
USE CODE
43 d
OF
UTILITIES-�
Public ❑ Private
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisionjthis
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances govetype
of work will be complied with whether specified herein or not. The granting of a permit does noilding
to give authority to violate or cancel the provisions of any other state or local law regulating constructperformance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
mbing
/V
DATE OF APPLICATION /�SIGNATURE OF APPLICANT
ch.
SPECIAL APPROVALS
NAME DATE
Env. Health
PlaP/.fv Pili
Hing
Fire Marshall
SPECIAL CONDITIONS:
MAI' 6lf�WU111QrS ND
Co. Engineer
Utilities
Plans Examiner
Ohd C)S-1 u'
5 PA Checklist
Bdin4technician 0
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $3`V5.60
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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