1980, 06-30 Permit: 80-6490 Residence, Renewal of 79-2163PLAN NUMBER
Lr
Q.
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. 6.7Liz41 'Vow r- "nares,
LOT BLOCK SUBDIVISI N
2.
OWNER
3. R/CHR2o a6-,?qnG'
ADDRESS
6 . /O of/49 4f9/VT6Ornt?e d
CONTRACTOR
LEGAL DESCRIPTION - SEE ATTACHED
4.
snort -
PHONE
9/4 -rise
PARCEL NUMBER/5 0?zr3_ 034,
W. e6T a F E • 497 ` c7t rarer /O Rgra
yriaEEti/�C.eev /RP. lae5 PEK7
ZIP
ei7%ZOG
Actual Set Backs In Feet
North 'South East • 'West
PHONE
Size of Parcel Zone Classification
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ONo D Req'd. -
5.
DESIGNER
PHONE
Valuation Building Area In Sq. Ft.
/ZSz
ADDRESS.
ZIP
Main Floor
/532
Upper Floors I Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
/532
TYPE
7. OF
WORK
Il NEW 0 ALT. 0 AD N. 0 RPL. D MVE.
❑ BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
r OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
N ot-Roq'd.
DESCRIBE WORK
6/4-2,,4...yyy��` — Rc5/eocZce
9.
LUATIONI SOURCE GAS
�
OF •
UTILITIES
Enum. Dist.
Location (Area)
ELECTRIC
WATER
SEWER
Ownership J/
Public 0 Private
USE CODE
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 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 INSPECTIONS
DATE OF APPLICATI Of�' 3 O 10SIGNATURE OF APPLICAN�/YJea le
SPECIAL APPROpl LS
NAME DATE
Env. Health
Planning ,
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Byµd di Tech cian
reTA ‘/C433
SPECIAL CONDITIONS:
79-2!63 PCN +f+c
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building 4e/P,-00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /B OC)
24-ERMIT!1UMBER
So-64lgo
02* *1800
*1800
*18006
E *Q00 3
64872
06-30-80
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
b C5i:H;3t,;0 X8110.
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
64-9.05 *18.00i2r -
PERMIT NO. TOTAL