1980, 04-16 Permit: 80-3572 Residencel
'–AN NUMBER /A
B ADDRESS
1.f Of NJ
LU r BLi
2. 81
94NER
3.
ADDRESS
3,5--7
CONTRACT
4. _icar.iu,virw
A DRESS
A41Pfj__
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 4 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
B IVISION PARCEL NUMBER/S 4—d%dy
41 Age,
PHONE kdT,f?%IriCrR4 HIFiAZ14T-S
', 346
ZIP Required Set)Backs in Feet
99.20%
PHONE
ZIP
PHONE
ZIP
CHANGE OF USE FROM TO
6.
TYPE SCI NEW El ALT. ElElAD'N. 1:1 RPL. 11MVE.
% ❑OTHER
WORK BLD. ❑ PLMB. MECH: M.H. POOL
A
D SCRIBE WORK / r e
8. .O, i 2J,1AI Yl i11� .fin // //A A], 01.
;ize of �arcel
Zone Classification
qa x,2//)
APP
Type Const.
Occupancy
Sprinklered
❑Yes 'KNo ❑ Req'd.
✓aluation
0 G
Building Area in Sq. Ft.
DWL Are
Basement Area
Garage Area
Storage
.Z5.3 9G
= -5�96
74
--
Split Entry
Split
Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
I
ERTIFICATE
Req'd.
Recd.
Not�R®e(
of EXEMPTION
I
>C
VALUATION �j S6urce GAS ELECTRIC WATER SEWER
9. �( Utilities ✓`�('1 IJ , l/
I hereby certify that I have read and examined this application and have read the "NOTICE" rovisions included
on reverse side, and know the same to be true and correct. All provisi sand or na ces governing this
type of work will be complied with whether specified herein o . he 1 g of a rmlt does not presume
to give authority to violate or cancel the provisions of any ther ate or al la reg ating construction or the
performance of construction.
DATE SI
DEPT.
Env. Health
Planning .
Fire Marshall
Co. EngineerG
i
Utilities
Zone Clearance
SEPA Checklist
FEES COLLECTED
Single $
Building
Plumbing
Mech
SPECIAL APPROVALS SPECIAL CONDITIONS:
REQ'D. RECD. / � App/' c- Plan Check
SEPA
"G, LV Mobile Home
DATE
PERMIT NUMBER --I
Other (Specify)
FLAW � ! �ilu TOTAL $ � D0
WHEN MACHINE VALIDATED IN THIS SPACE,
r THIS.E�C01>/IE/S A P_�RMIT. 7
DATE_10 /6 F CIA .. j 7 .i l`t r1 /,' +
L 0 1
PLAN NUMBER
->/��7
e
J
APPLICATIO14/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
SCRIBE WORK
8.
1i
B ADORES
FEES COLLECTELin.
VALUATION �0 S urce GAS
of/J}�
LEGAL DESCRIPTION SEE ATTACHED
SEWER
LO
BLOCK
UB I I ION
11,l
PARCEL NUMBER/S
4g
2.
$
C
AJI iroviT� 0 . �:eC
SyWNER
Building A r
PHONE
� Q'/ S k1 �� aL
H,1C ,-14 75
3
_..
;
� rn'27�0
n/EO /T
-C -,c',- pmA� r
Mech.
A{pDRESS
///SDs �A
ZIP
Required SetPacks in Feet
r / /East
--"` p /
t i �`r`2 �-''
-4A"
�7 ee
North South
Q West /B /
CO TRACTOR
PHONE
Size of Pprcel
Zone Classification
'Q
90 7C 2 /O APP
4.
RZESS
A
ZIP
Type Const.
Occupancy
Sprinklered
Oyes No ElReq'd.
DESIGNER
PHONE
V luatlon G
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
OWL Arep
Basement Area
Garage Area
Storage
.?v 9G
ec J 9
7G
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.,
TYPE CK NEW
❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
No. Baths
No. Floors
No. Rooms
F7.
Rec. Room
OF
❑ OTHER
WORK X BLD.
❑ PLMB. ❑ MECH. ❑ M. H.
❑ POOL
ERTIFICATE
Req'd.
I Recd.
Not Req'T
of EXEMPTION
1/
SCRIBE WORK
8.
FEES COLLECTELin.
VALUATION �0 S urce GAS
of/J}�
RIC WATER
SEWER
q _U-
9. D UOd Utilities
TEFC
�"`'1
lG
Single $
C
AJI iroviT� 0 . �:eC
q jPr �.io this
Building A r
Plumbing
- - ----
— --
Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
4/2 12-'"
Fire Marshall
Co. EngineerG,
Utilities
Zone Clearance
ist
SPECIAL CONDITIONS- ,J
/ • ,f /,,��- (' Plan Check
0 SEPA
•"S��' ' ' ` Mobile Home
P" 1* T % Other (Specify)
�j D U
TOTAL $
DATE � F,FICIA Q
DATE
PERMIT NUMBER
7-2
1
3 1. 2 c.5 * 4 4 54 :Lj
.c
3 1. 2 c.5 * 4 4 54 :Lj