1980, 04-04 Permit: 80-3114 ResidencePLAN 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 LEGAL DESCRIPTION — SEE ATTACHED
�. /g
OT I BLOCK 150113DIVI510INPARCEL NUMBER/S add
2. T c /
O N RI PHONE �Ur' ' 04K .Z A41dA PARK ADD
3. —
DARE ZIP Actual Set Backs in Feet t
(/jD / 7 North / 1d South �East , West �J
CO TRACTOR PHONE Size of Parcel Zone Classificatio
:37
4' ADDRESS ZIP Type Const. Occ6parIcy fSprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE V�uation Building Area p Sq. Ft.
'� cs d.
5. ADDRESS ZIP Main FI or Upper Floors Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
TYPE No. Baths No. Stories No. Rooms No. of Dwelling
1 , NEW ❑ ALT. ❑ AWN. ❑ RPL. ❑ MVE. 1:5
1 A2
% WORK 1:1BLD. ElPLMB. 1:1MECH. 1:1M.H. El POOL ❑OTHER CERTIFICATE Req'd. I Recd. Not Req'd
of EXEMPTION A
D CRIBIr WORK Enum. Dist. Location (Area)
8 FEES COLLECTED
VALUATION] SOURCE GAS ELECTRIC WATER SEWER Ownership 1presume
LI Public ❑ Private
UTILITIES
Single $
1 here6y certify that I have read and examined this application and have read the "NOTICE" provd
on reverse side, and know the same to be true and correct. All provisions of laws and ordinancess y ` �,q
type of work will be complied with whether specified herein or not. The granting of a permit doe Building
to give authority to violate or cancel the provisions of any other state or local law regulating conseperformance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SPECIAL APPROVALS SPECIAL CONDITIONS:
I-% NAME DATE
annmg
re Mar
Co. Engineer
Utilities
Plans
Examiner
TDn�PA Checklist
Building Technici _ PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
1'ERM1,NUMBER
1 S '
02* *29200
*29200
*29200
E *Q00 "
Cl
31 1,3z
04=04-F0 _
z 6,479.
Mobile Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
X14;-04-80 51L4 292,002 -
os