1980, 03-10 Permit: 80-2011 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT b0aft/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 3/f6�&D
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS U G k h 1
1 � 9B/LOCK � LEGAL DESCRIPTION —6:: ATTACHED * < ;
L T S BDIVISIO PARCEL NUMBER/S P���-� i' ���d�
2 OWNER �c� - 'c -' LOTS 131-1C-.2 H,eMDR1cKi',v .suc3 r , 'c c.
OWNER PHONE C .C. ,
3. c<>11444-0 e -itzt cd q2*-996,4, 36--z 6 -4
,�DDRE/S/SyI /%(/e 0 D ZIP Required Set Backs in Feet/i 1 7 6./ ,`'
„ j 11 .!',/S -�Y� �� !/r� �'./jGQ,I.�. qQOi North fay— 'South.2 East 7� IWest , �`
CO TRA R / PHONE Size of Parcel Zone Classification ( z,
441A44../._ 8t X/3 k
� ALL-, 6 Li. 7 4
4' A DRESS ZIP Type Const. Occupancy prinklered
V-A/ R-.5 ❑Yes 1:$1.No ❑ Req'd.
DESIGNER PHONE Valuation Building✓� Area in Sq. Ft.
5. .2c7/4,
ADDRESS ZIP DWL/ Area Basement Area Garage Area Storage
/./.4,a1I '72' S'Z '
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6. X _— --
No. Baths No. Floors No. Rooms Rec. Room
TYPE lI NEW El ALT. El AD'N. ❑ RPL. ❑ MVE. / (v
7, OF ❑ OTHER02—
WORK k BLD. ❑ PLMB. ❑ MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION X
D E� I B WORK id
G g� r n14 c'�r�_
8 //✓�, Fi _/( FEES COLLECTED
yALUATION ource GAS EL CTRIC WATER SEWER
9. ,c,��' z66 e6 Utilities
ies Single $
—
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 Building 2-�'r
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 regulating construction or the
performance of construction. Plumbing
DATE .� " d' Q SIGNATURE d Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: j- i
DEPT. REQ'D. RECD. Plan Check
Env.Health , j. C.�
' ' ,�����/� ,C.R/a.�t� 1��'�1'�y��/� O SEPA cc
Planning 6� p- f.zia4 U
w
2
Fire Marshall Mobile Home
Co. Engineer ) t_-12-ft,� Other (Specify)
3 7 d,' ,,44_,, /1
Utilities " ;I"- .--riZi.X HMI/ '12 o1A11\1
TOTAL $ .:2.10/71
Zone Clearance P k''` s"`'l R R7,' riEg=it r(1s••,i
C r ,,_ }f 4; i'S C::',:::3
.3. WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist • THIS BECOMES A PERMIT.
..--- i il DATE 41/4461 OFFICIAL /62 a I U - -
kPeAta.�.O n:l`=,c S tRIP, ciNT•1 APPROVED R ISSUANCE -
ARNOLD'S CONSTP"^TION
• P. O. B 0X 21 3
NERADALE. WASH. 99031
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