1980, 12-12 Permit: 80B-4830 DuplexPLAN NUMBER
✓ ell
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
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
LOT
BLOCK
SUB ISION
PARCEL NUMBER/S
2. J
,c.0 r
OW ERPHONE
1
9.2 - '�
W Y14 7" D
s.
dN
A D ESS ?
ZIP
Actual Set Backs in Feet
i 3 3!!� 0
q 9Zd Cr
North Z South: -2,T
East West .,21�5
CON RACTOR
PHONE
Size of Parcel j
Zone Classification
2
9G', `%' J 2 2-�-
4.
AD RESS
ZIP
Type Const.
Occupancy
Sprinklered
V—N
IZ. -3
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
V luation a
Building Area in Sq. Ft.
& ,tk'
5.
12
ADDRESS
ZIP
Main rloor Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
_"'
--
zj 10 0/
TYPE I�
yq NEW El ALT. ❑ AWN. ❑ RPL. ❑ MVE.�
No. Baths
No. Stories
No. Rooms
�AL�
No. of Dwelling
7, OF ❑ OTHER
�7I
b4 BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
X
D SCRIBE ORK
Enum. Dist.
Location (Area)
FEES COLLECTED
8 _
VALU ION SOURCE
GA
ELECTRIC
WATER
SEWER
Ownership
USE CODE
O OF
UTILITIES
Public ❑Private
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
3r,
type of work will be complied with whether specified herein or not. The granting
of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or local law
regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION&
Plumbing
/ 1 %f
r1ATF Or APPI IrATIf1Al ! r4 `V—�LL Cl/:AIDTI IRC nc ADD] IrAnl-r :I,�..[ _/,-)• /cL.,..�.-�
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE /
Health (zA R-Aa.ES / �Z X .Z.Z .6.jc,,/ uwiTN s -A,6
inina
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
-TOM Y' -:-T, W -r
SEPA Checklist
B ding Tech ,cian
PERMIT IS NONTRANSFERABLE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBE
J C
l 0 Y
�I. Ci C
4 2"__.
_--12--80
5'.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12;r"I� '80' 48 0ZI *382000J
CIO. 44