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1980, 06-17 Permit: 80-5900 ResidencePLAN NUMBER / Z- � APPLICATION/ PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 TYPE Ig NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. �2 1/y APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS 7, OF ,yy�� El OTHER L1 BLD. ❑ PLMB. ❑ MECH: ❑ M. H. ❑POOL CERTIFICATE LEGAL DESCRIPTION — SEE ATTACHED Recd. OG i Gia of EXEMPTION X DESCRIBE WORK 8. � : � � LOT LOCK /r7�c �r1< PARCEL NUMBER/S 2.l3ISUBDIVISIONO Single $ 1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included 4 on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building 7-73.00 type of work will be complied with whether specified herein or not. The granting of a permit does not presume �2 /3 OWNER Plumbing DATE C— f (Z.l O SIGNATURE Q' W Lj PHONE 3. ADDRESS Required Set Backs in Feet E, ZC. �s{ I2 //ZIIP 'l� a0c, North LS South ` East +8 West ZS) CO�RACTOR / r1 S r�1 C}� PHONEY �(,'•/yfj Size of Parcel I�5.. Z ne Classification Fctr+�.�. �. 4. �✓1c e ADDRESS Kane c Ka ZIP ZI '7 �1 99 0 � TypeType Const. Occupancy Sprinklered ❑Yes 1ANo ❑ Req'd. DESIGNER PHONE V I ation PJ Building Area in Sq. Ft. 47 gp�t 12G�. 5. ADDRESS ZIP DWL Area Baseme t Area Garage Area Storage e�✓ � I "CUQ CHANGE OF USE FROM TO try Split Level Rancher 6. '-1 p " No. Baths No. Floors No. Rooms Rec. Room TYPE Ig NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. �2 1/y 7, OF ,yy�� El OTHER L1 BLD. ❑ PLMB. ❑ MECH: ❑ M. H. ❑POOL CERTIFICATE Req'd. Recd. Not Req'd WORK of EXEMPTION X DESCRIBE WORK 8. � : � � FEES COLLECTED � Gi v -n ., -�, c� � � K In -�-� i. � � fl C` � h G A Y C+ c e C� LUAT N Source GAS ECTRI WATER SEWER Of 9. Utilities Single $ 1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included 4 on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building 7-73.00 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. Plumbing DATE C— f (Z.l O SIGNATURE Q' W Lj Mech. SPECIAL APPROVALS DEPT. REQ'D. RECD. Env. Healt Planning Fire Marshall Co. Engineer Utilities Zone Clearance SPECIAL CONDITIONS: SEPA Checklist lI I tl~A_�s yj l Aifei�,W /DATIF / -/li'7.*t) 1n FFICIAL Plan Check SEPA Mobile Home Other (Specify) DATE PERMIT NUMBER 8b- !;1©0 TOTAL $ <%-763-� WHEN MACHINE VALIDATED IN THIS SPACE, ,THIS BECOMES A PERMIT. ROTH DEVELOPMENT AND CONSTRUCTION CO., INC. E. 10126 FERRET DR. SPOKANE, WA 99206 9.28-29'18 of 13 mica Park Addition MICA PARK DRIVE c3 N SCa� - l"' "2o�