1980, 04-11 Permit: 80-3408 AdditionPLAN NUMBER t
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
ie /86)7
LOT
2: a
OWNER
BLO K
i
SV ISTD
R2/U-li14-U•LGUI--
PHONE
922-1279
15
3.
A DRESS
4.
rJ � . d'0.4 r9.4elu 44.,
[1
r / rt h7 7 »j -tLN / "//ALLEN N
CONTRA�C�T/fOR
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S e 75-67-193 &.Q
/47 2 J3L)C
RIL4 R✓/EIU MOL3/ho HOMO Sut3 •
ZIP
9go47
PHONE
Actual Set Backs in Feet
North`745% / (South ell /
Size oY Parcel
East rlS 3/ JIWest 2/ '•
ADpRESS
AM•PJ
ZIP
Type Const
✓-r@
' Zone Class
Jett,2
O
ccupancy
Ification '
21.4141/x/ 144Q1
Srrinklered •
❑Yes ❑No 0 Req'd.
5.
6.
DESIGNER
PHONE
ADDRESS •
CHANGE OF USE FROM
ZIP
V Iuatlon
goo° �.
Main Floor •
3 deo
, Building Area In 3q. Ft. •
/,o
Upper Floors Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ALT. yA AD N. 0 RPL. 0 MVE.
❑ PLMB. 0 MECH. 0 M.H. ❑ POOL
0 OTHER
No. Baths
No. Stories
/
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WOR
8.0% r eM
yy((� VALUATION
9S'ODd d�
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 INSPECTIONS
DATE OF APPLICATION "9-gD SIGNATURE OF APPLICANT
OURCE
OF
UTILITIES
— A.V4.24/ ACo-e-Put -
GAS ELE TRIC WATER
-1fi'1 14
Enum. Dist.
Location (Area)
SEWER
Ownership
Public 0 Private
USE CODE
Env
SPECIAL APPROVALS
NAME DATE
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examine
SEPA Checkli
Bulldin. Te hnici.n
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF. ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA .
Mobile Home,
Other (Specify)
TOTAL 16 g'
view ,-( ERMIT NLdav1BER
1Bo.-3$0'B
02*• *68.0;0
*6800
340.7P
04-'11;=80
&,6,479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 4 =,O1'.'1t.z;8''01 - 3 4 0.8 Z * 6 8.8 8,U -
DATE ISSUED
PERMIT NO. TOTAL
t
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