1980, 01-03 Permit: 80A-9741 RemodelPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
7714✓J
LOT BLOCK SUBDIVISI
APPLICANT: COMPLETE NUMBERED SPACES-rPRESq HARD TO MAKE 4 COPIES
2.
OWN
a DS
ADDRESS •
�. 974.s
COkYTRACTQR
4.
5.
PHONE
✓tea-ac-�f.—
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
East 'West
ADD& SS- s /J
ac3 ci-/�d.
DESIGNER
PHONE
4/373 -07o as
ZIP
„.0107
PHONE
Size of Parcel • Zone Classification
Type Const.
Occupancy - - Sprinklered
Oyes ONo 0 Req'd.
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area I Basement Area
•
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
0 NEW
❑ BLD.
lE ALT. 0 AD N. 0 RPL.
Ild'PLMB. 0 MECH: 0 M.H.
❑ MVE.
o POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DES RIBE WORK
8.
VA DATION
9.
Source GAS ELECTRIC
of
Utilities
WATER
SEWER
I 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 correc . 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 lo al law regulating construction or the
performance of construction.
DATE �.y tix—. ./ 970 SIGNATURE
DEPT.
SPECIAL APPROVALS
REO'D. REC'D.
Env. Health
,Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
;
d CG gar. #
/�tJ.,4_ 99ao7
-0.3/-1/!1
DATE OFFICIA
APPROVED FOR ISSUANCE
FEES COLLECTED •
Single $
Building
Plumbing
Mech-
Plan Check
SEPA
Mobile Home II >>
Other (Specify) v• "
TOTAL /S,S'O
/4.30
PERMIT NUMBER
5r OA -97i'/
DATE /— 6 ot— — 70
03* *1550
* 155,0
* 155.06
E *000
974Og
• 01-03,"80
6479.- _
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01:7'03::0'
9`741= *15.:5:0:al�.
0
0
W