1980, 02-26 Permit: 80-1544 Residence •
IrLAN NUMBER
PLAN APPLICATION/PERMIT PERMIT NUMBER
R.-- $' SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7a�/fi5
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE Z~Z-o-247
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
02 * * 26400
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED * 2 6--�U 0
1. /1". /47v 5 A2e-c 3 .Po
LOT BLOCK SUBDIVISION PARCEL NUMBER/S eor 7 ace/ * 2 6./I 0 0 Y
2. —7 I i AC-NPR/eics-p/�! >S .
OWNER ' PHONE D' * O 0 0 ,
3. yGO /�.eitt000 926-09.'2 ?a e, 3s4 se3 0606 1 5 4. 3
ADDRESS � ZIP
w� Required Set Backs in Feet
E. 75 Ee-a6 V O,?. 5)7114-Awe 172Go North /�' 'South 2S/ East 754 'West .3S? 0 2_2 6'—8 O
CONTRACTOR PHONE Size of Parcel Zone Classification
S',9mc= k3'X'0j 4' S,'iJ ,E Fi9ihscy a 6.4 7 9.
4. ADDRESS ZIP Type Const. Occupancy Sprinklered of
54 ME- U—N -.3 Dyes ❑No ❑ Req'd.
DESIGNER PHONE Va cationp0 Building Area in Sq.Ft. ..
44f.5-2RG --XX Z3/c/ ., _
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage
//60 I .5-72' SOO/ —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6. X
TYPE ,-,,� No. Baths No. Floors No. Rooms Rec. Room
L7 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 2 I b '-___
7. OF (/ ❑ OTHER
WORK BLD. ❑ PLMB. 0 MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Reg'd.
of EXEMPTION 1�
i DESCRIBE WORK
8. RV-S/DEisicE, -G/�K. GE U Df.R-- '—O /A—f' -/ c rCiD FEES COLLECTED
VALUATION Source
Source GAS ELECTRIC WATER SEWER
V j /6 -- of F SCy�
9• �S/ 2 yY Utilities /l �'T TIC. Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included00
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building -Z�q• kX
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 regu . ng instruction or the
performance of construction. Plumbing
DATE SIGNA IRE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. PI,fT 4 i iM Per Plan Check
Env.Health �j w Si rotiiA,I C.V.)/ r(e.E >x
��r�CJ ��//� SEPA
Planning / ` — LL
a
Mobile Home v
Fire Marshall Z.—
Co. Engineer Other(Specify)
Utilities z,i,"00
TOTAL $ 2 ?V
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
6 THIS BECOMES A PERMIT.
SEPA Checklist Pt-ANS450, ► 1Z-1�1 okl>Gt, y31 �9 ,.
i
DATE OFFICIAL ... h % G U C_
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