1980, 04-02 Permit: 80-3015 AdditionPLAN NUMBER }
2—fie
JOB ADDRESS
,.1010
I
LT . BLOCK
2.
OWNER
3.
ADD ESS
. 11& 0
CONTRACTOR.
4. ADDRESS
DESIGNER
5. ADDRESS
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
SUV LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION PARCEL NUMBER/S
PHON - — '" V A r;� 8
/ Actual Set Backs in Feet
North South Jr East 30 West
PHONE Size of Parcel 1z;%assificat')ni
V- -,- 3�e-Ic <� -
ZIP Type Const. Occupancy Sprirfklered
❑Yes ❑No ❑ Req'd.
PHONE Valuation/O t O� Building Area in Sq. Ft.
ZIP Main Floor Upper Floors I Garage Area Storage
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
s.
TYPE,�,/,r No. Baths No. Stories No. Rooms No. of Dwellings
❑ NEW ❑ALT. Ild AD'N. El RPL. ❑ MVE.
7 OF WORK CI BLD. 1:1PLMB. ❑ MECH. ElM.H. 1:1 POOL 11 OTHER CERTIFICATE Req'd. I Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WOR + I I Enum. Dist. Location (Area)
8. G'N �{�� I 6 X I� 6 FEES COLLECTED
VALU ION SOURCEOwnership GAS ELECTRIC RIC TER SEWER USE CODE
9. I 00(o OF I
UTILITIES Public ❑Private ❑
Single $
I hereb certify that I have read and exami ed 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 Building
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 Plumbing
DATE OF APPLICATION 3 -2 / - 942 SIGNATURE OF APPLICANT%� be�� I Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE tai ,/Lr-l�7�1C� Plan Check
Env, alth I � Vn �l
SEPA
PI nning
Fire Marshall Mobile Home
Engineer
Utilities
Pians Examiner
TOM P®S'T-F=0AlT
SEPA Checklist
Other (Specify)
PERMIT NUMBER
02* *80,00
*8000
*80,001
E *0.00
301.49
04-02-80
6,479.
TOTAL $80-00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
niciaRI PERMIT IS NONTRANSFERABLE I 4— Q 2'- 0 110 1. 5 �� 8 0. 0 0 d l-
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