1980, 12-19 Permit: 80B-5090 MH PLAN NUMBER ---1 APPLICATION/PERMIT PERMIT NUMBER
r /1.2-//9./k. SPOKANE COUNTY - BUILDING CODES DEPARTMENT 15",43___
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NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
/ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED 0 ' * * 1 0 O. 0 0
1. 5. 12'1210 .•• A1\ * 10O. 00 1
LOT BLOCK SUBDIVISION PARCEL NUMBER/5
2. N4 116'. 1c1 0. wool o� 6.,00 9q¢ 14- a3- 41�el-P .1 * 1 0 0:o 0
� r I Ic j v ar I —r qo. ` � 4- u� r * 0 0
OWNER �r PHONE C
3. I I i' i0'J O I (A'r 96 ` % 777 rl : 9-.5
ADDRESS Z q-��,,aa�, Actual Set Backs in Feet I�A 5 0 9 ;Q
1511 17 / f^`' 3 North 'O ISouth East 'West v `' 1 - 1 9-8 0
CONTR C pyo PHONE Size of Parcel Zo a Classification
4. ADDRESS ZIP T p Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Buildin grey in Sq. Ft.
s. a0 Onn ,,r,V,
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE �/ No.Baths No. Stories No. Rooms No. of Dwellings
LI NEW 0 ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF CI OTHER -
WORK
El BLD. CI PLMB. 1:1 MECH. IY.M.H. 0 POOL CERTIFICATE Req' . Rec' . Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. f Location (Area)
8. Moe' LK/16( 2-z- (00I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WAT R SEWER Ownership USE CODE
? f7 0 OF
9. 01, 0(90 UTILITIES � SLG Public 0 Private
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
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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 construc '.n or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTI0 ��S r Plumbing
/
DATE OF APPLICATIOhy 'p�(5— ° SIGNATURE OF APPLICA, I_ �' ��.,' Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env.�rHealth
C4 x, /...-/9"ge, SEPA 2
Planning _
V
Mobile Home ' "1
Fire Marshall f "-1
Co. Engineer ir-
• Other(Specify)
Utilities I 0 C?
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
•
Tec n PERMIT IS NONTRANSFERABLE �, �jn�
- C PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE I SUED �, PERMIT5A 0`2. *10 0' 4 ,?LI'
OFFICE OF THE
SPOKANE COUNTY PLANNING DEPARTMENT
i
. Dole__ / -- .1930
/--
.. o Bu1lding Codes Department "''; `4;""`
•om Planning Depdrtinen.t .. _.. . .__
ubj•ct._. guildtng•Permit . _ _ __. ___.. r__. ____
The Planning Department has received a request from
,Q.4zi/421 S7"EGtl4-47 for the release
of a building permit on the property as described on
the attachrjqd affidavit/legal description. It has been
determined' that a building permit should be issued
under the provisions of RCM/ 58.17.210. This memo
and attached affidavit/legal description must accom-
puny the building permit application.
**This release will not authorize the holder to construct or apply for a
I building permit to construct more than one residence on the lot described
_/
below. � .C� � ,/_ �.!/��`
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