1980, 05-05 Permit: 80-4331 Pole Bldg, GaragePLAN 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
,1. -;� C
LOT/ B1= CK S BDIV 10N ,
2. / e.—iuGGC'l-
OWN E
3.
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
S5
ADD RFrSS
ZIP
Actual Set Backs in Feet SS
North 4]/ ISouthy.? , East /.t / IWest..J
4. ACDRESS
CO
TRACTOR i
PHONE
?- 15s
Size of Parcel
72 sCl 41
Zone classification
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER
HONE
ADDRESS
ZIP
V uation G
Mafn Floor
72 '
Building Area n Sq. Ft.
()
Upper Floors
Garage Area
7z0�
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7, OF
WORK
NEW 0 ALT.
BLD. 0 PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
DESCRIBE W RK
8.
GAS
VALUATIOII SOURCE
OF
UTILITIES
ELECTRIC
�/
WATER
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
No. Rooms
Req'd.
No. of Dwellings
Rec'd.
Not Req'd.
SEWER
Ownership
Public ❑ Private
USE CODE
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
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. SEE REVERSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION — 0 SIGNATURE OF APPLICANT At/I.(e
SPECIAL APPROVALS
NAME DATE
Env. H
Planning
bie4e040-A
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Z29TCh nin
/L1A
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
t
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 1146
IOW f NUMSTR
g -o 4/
02* *44,00
*44,00
*44.006
E *000
4330.5
05-05-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
`05;_0'5- 0
DATE ISSUED
433,1°
PERMIT NO.
*44Q0°�
TOTAL
O
C
C
u
COOK BROTHERS CONTRACTING
Route 2 Box 853 B
OTIS ORCHARDS, WA 99027
(509) 924-1557
JOB
OY /02/6 -.4 -
SHEET
SHEET NO
CALCULATED BY "Zletr"
CHECKED BYc',C/�'y.'
SCALE L '` _30
DATE
ry
FORM 201 Available from ( EBSI 'NG Townsend. Maas 01470