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1980, 03-04 Permit: 80-1780 Pole BldgPLAN NUMBER JOB ADDRESS 1. r -/ L T B 2 O'' ,,,, W, N1 ER 3. 1 ADDRESS NT �?C 4'"ID-DRESS DESIGN I 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 SrA SUBDIVISION T, PARCEL NUMBER/S /1 IJ IIZEiA 1,1d�IITIKIL (iiEu.? j%,iDr3; Li /4,0 -AC .4�. P ONE 1 ZIP Re d Set Backs r in Feet t r 1 < N r outh 3 East West OR PHONE Siz of rcel Zone Cla9ffniCalgn �f ZIP T pe Const. Occupancy Sprinklered PHONE ZIP CHANGE OF USE FROM TO 6. TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7 WORK BLD. ❑ PLMB. ❑ MECH: ❑ M.H. El POOL OTHER OF ❑ ES RIBE WORK j s 8 ` _ _ _ ' �� art �/ FEES COLLECTED VAL ATIO Source GAS ELECTRIC WATER SEWER of 9. 0 Utilities 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 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. Plumbing DATE ` 3 — SIGNATURE Mech. SPECIAL APPROVALS SPECIAL CCONDIT�INIfON�/I I p DEPT. REQ'D. RED. O I LV�J Plan Check j Env. Health SEPA Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist 60d `Cd Mobile Home Other (Specify) DATE OFFICIAL TOTAL $ PERMIT NUMBER �:] r�o DATE_ 1 7 G )`l'v r 679 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. �cf4n� 'nr ❑Yes ❑No ❑ Req'd. luation Building ry,rea.in.aoq. Ft. DWL Area Basement Area Gara e Arrea1 Storage Split Entry Split Level Rancher No. Baths No. Floors No, Rooms Rec. Room CERTIFICATE Req'd. I Recd. Notpeq' of EXEMPTION 8 ` _ _ _ ' �� art �/ FEES COLLECTED VAL ATIO Source GAS ELECTRIC WATER SEWER of 9. 0 Utilities 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 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. Plumbing DATE ` 3 — SIGNATURE Mech. SPECIAL APPROVALS SPECIAL CCONDIT�INIfON�/I I p DEPT. REQ'D. RED. O I LV�J Plan Check j Env. Health SEPA Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist 60d `Cd Mobile Home Other (Specify) DATE OFFICIAL TOTAL $ PERMIT NUMBER �:] r�o DATE_ 1 7 G )`l'v r 679 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. �cf4n� 'nr w - . - IV)'