1980, 04-21 Permit: 80-3701 Moving ResidencePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WAA`HINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1.
117-O _ J
406 BLOCK rtirtrS/14g1-r(
ra.sc2�-/��S IS
3. O Fr �•. ��N�
A D D RE13 4.1+ 56, ,1T4 Tj
CONTR( ACTOR �/
ADDRESS
4.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
PFjpN-5g4)
• -24:244-- I reD.,
z"="3-49
PHONE
Actual Set Backs in Feet
North 'South
East
'West
Size of Parcel1 5v I Zone Classifigation P5C
-ewu
ZIP
Type Const.
Occupancy
rinklered
❑Yes ❑No 0 Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
,.�
ADDRESS
ZIP
Main Floor
Upper Floors Garage Area Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
7.
8.
9.
TYPE
OF
WORK
❑,/NEW 0 RPL.
GeBLD. 0 M.H.
DESCRIBE ORK
SIN� P515:51° G�
VALUATION SOl3RCE
OF �GAS ELE17 IC
UTILITIES
B ALT. ❑ AD'N.
0 PLMB. 0 MECH.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not F�q'd.
Enum. Dist.
Location (Area)
WATER
COMM'
SEWER
�
Ownership USE CODE
Public 0 Private_let
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 APPLICATION
h► -17- (Po
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Tech1
i1�
.I SPEC CONDITIONS:
MAN/ of L 9,0 71- ( w 02.4.. WO)
"kw -
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
02*
* 59.00
* 59,00
364,2
r04-17-80
6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
04'i-21'-0 370,12 *59.00a� _
c
u