1980, 03-13 Permit: 80-2183 ResidencePLAN NUMBER
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OWNER
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ADDIRESS
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C70NTRACTOR
4. ADDRESS
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
LEGAL DESCRIPTION - SEE ATTACHED
S I_I PARCEL NUMBER/S �i i, /8 fs
PHONE "7-A:5' A341< k
IM ADD
ZIP r Required Set Backs in Fee
% 9,494
PHONE
ZIP
DESIGNER PHONE
5. ADDRESS ZIP
CHANGE OF USE FROM TO
6.
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 ❑OTHER
WORK ® BLD. 1-1PLMB. ❑ MECH: ElM.H. ElPOOL
orth le
jSouth/fEast
'Y lWest -3/
ize of Parcel
WATER
Zone Classification
-76 1)c 12WWoc
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Utilities o ties
Type Const.
Occupancy
Sprinklered
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❑Yes ❑No ❑ Req'd.
ation
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Building Area in Sq. Ft.
—xV
9 o
OWL Area
Basement Area
Garage Area
Storage
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1 zt3 4
44o
—
Split Entry
DATE �"/V —�� SIGNATURE
Split Level
Rancher
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
N MW
Plan Check
No. Baths
No. Floors
No. Rooms
Rec. Roo M.
Z
1 1
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CERTIFICATE
Req'd.
Recd.
Not Req
of EXEMPTION
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Co. Engineer
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VALUATION
Sburce
GAS
ELECTRIC
WATER
SEWER
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Utilities o ties
FA
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
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on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building so ✓
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 regul ting construction or the
performance of construction.
Plumbing
DATE �"/V —�� SIGNATURE
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
N MW
Plan Check
Env. Health
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SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
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Utilities
00
TOTAL $ —0—L�&
Zone Clearance
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PLAW 3"�"�DC�
WHETMACHP INE VALIDAI
SEPA Checklist
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