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1980, 11-24 Permit: 80B-4117 Soffit, Fascia/yav/4o 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 2. JOB ADDRESS LOT /BLOC I0 CO K 3. OWNER S,morou) 2trid, SUBDIVISION AV>IO • to orrictud PHONE 1414 -0207 / "t-ta o� ADDRESS mnrroi3 eoa& LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S tp4) 01 f d ZIP R v -/G Actual Set Backs in Feet North I South (East 'West 4. 5. C NTRACTOR C Va-`1 satiA tAJ ADDRESS AJ 3-/% /4-r-onni PtakL. DESIGNER PHONE gag-ijj084 Size of Parcel ' 1 Zone Classification =IP99ao% Type Const. Occupancy Sprinklered Dyes DNo 0 Req'd. PHONE Valuation , _ 60 Building Area in Sq. Ft. ADDRESS ZIP Main Floor Upper Floors 1 Garage Area Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Basement TYPE 7. OF WORK D NEW BLD. D ALT. 0 AD N. 0 RPL. 0 MVE. D PLMB. 0 MECH. 0 M.H. 0 POOL 2 ^OTHE .R U - R No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION • Req'd. Rec'd. Not Req'd. DESCRIBE WOR 8. 7770- CELL' + VALUATION 9. agao, Oo SOUR OF UTILITIES GAS Enum. Dist. Location (Area) ELECTRIC WATER SEWER Ownership Public 0 Private 0 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 �� ��REVEERSE SIDE FOR REQUIRED INSPECTIONS y/ DATE OF APPLICATION �I//'�fV o SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities fans Examiner SEPA Checklist �eu9 Telpn c 110'0 SPECIAL CONDITIONS: PERMIT IS NONTRANSFERABL PERMIT EXPIRES ONE YEAR FROM DATE OF SUANCE FEES COLLECTED Single.. ' $3b .`"`-' Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 3$t trtt PERMIT NUMBER ao•& +I17 02* *3aoo *3800 *38006 A *GOO 8 4;1 1.68 11-24-80 8 6479. 0 V LtJ LL WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. .r I 4R:O'Z • 3'8.0.0 - DATE ISSUED PERMIT NO. , \ TOTAL 4.r-