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1980, 06-04 Permit: 80-5366 renewal N3506 Addition
PLAN NUMBER 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 1. I OtOT 2. OWNE 3 P.rc �S UB l Cv�i sI O -tel 1 (1 T[' C) l . BLOCK CD t_t__)-eJ,\. ADDRESS r_. (v-cD. LEGAL DESCRIPTION - SEE ATTACHED PHONE qa,4-0 4.19 ZIP GGa.1(a PARCEL NUMBER/S (/jL. :teC�4' /,,Li -r• .C1 �jc L• a, V ` L34 moi;' r ►- I \f3.4,.oc.,ac. 14 a I ©t �vs Actual Set Backs in Feet tc�-ki� North ,- 'South // East West 4. CONTR CTOR PHONE Size of Parcel ADDRE�,4� DESIGNER 5. ADDRESS PHONE ZIP tiType Const. Occupancy Zone Classification Sprinklered ❑Yes ❑No ❑ Req'd. V nation Upperrs Garage Area Main Floor CO I 941 Building Area in Sq. Ft. Storage CHANGE OF USE FROM 6. TO Area of Decks Finished Basement Unfin. Baserraent 7. TYPE OF WORK Ktl NEW it BLD. O ALT. ❑ PLMB. AD'N. 0 IrECH. ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL 0 OTHER No. Ba No. Storie No. Roo No. of Dwel ings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. ESCRIBE WORK 8. C3"' 3rJb (n Enum. Dist. Location (Area) VALUATION 9. SOU RCE OF UTILITIES GAS ELECTRIC WATER SEWER Ownership Public 0 Private 0 USE CODE 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 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 o he performance of construction. SEE REVERSE SIDE FOR REQUIRED I ECTI I S DATE OF APPLICATION—J t0k."' Q SIGNATURE OF A SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Errrtling;4.3nician SPECIAL CONDITIONS: * A -r me F'A'vr't ►..y Q, v.. atj !tiG C Ai— Pei-4)A`*rtx NYE, I% D A -T PERMIT IS NONTRANSFERABLE FEES COLLECTED Single Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ (t7 v0 PERMIT NUMBER (c(p c* *1000 * 1 0!, 0 0 * 10.006 *t; 00 J 5 3 6 5 06-04-80 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 0'6-0 V-8 0 536.60 *10.00a1--