1980, 03-12 Permit: 80-2131 Shed PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT `s4"02/`,/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
DATE 3-1Z-4"
k APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
0 2 * * 2 1 5 0
JOB ADDRESS
1. '� C�9 � n _rte LEGAL DESCRIPTION — SEE ATTACHED * 2 C 5 C t
LOT BLOCK UQ� I -I �1��-` PARCEL NUMBER/S ^- , ` ;_ ���y�O�� I 1 3 0
2. q N 'LX/�. ' p�- 12�8G
OWNER PHONE
12\
ADDR IP (� Required Se,Bac-Vcs in Feet {' 6 4 7 C/
.,J ,('` (j ( q9A-� 4 O ctc7 9,e)ci North 'South East (West
CONTRACTOR J PHONE Size of Parcel Zone Classification
ain
4. ADDRESS ZIP Type Const. Occupancy Spri klered
QJ _ €C.1. S-- Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuat.jon Building Area in Sik Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Arga Storage
CHANGE OF itJSE FROM TO Split Entry Split Level Rancher
6. / /
No. Baths No. Floors No. Rooms Rec. Room
TYPE X.NEW D ALT. ❑ AD'N. ❑ RPL. ❑ MVE. / / /
7. OFD OTHER
WORK 1'Al BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK.
� Aii� �3jJ Xf FEES COLLECTED
8 VALUATION $p ELECTRIC WATER SEWER
of / ......
/
9, 11 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 CuildinD A :
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 re lating construction or the
erf rmance of construction. Plumbing
:4
SIC T-Li _.---• Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. I` Plan Check
Env. Health G �pM�
QO '
&gee /�D/DO SEPA — I—
I
� w L%-1- 51-Q,
�r (� ter, CD
O
Planning �-+ `� 1,1;?.... w
2
Mobile Home rn
Fire Marshall z
t
Co. Engineer Other (Specify)
Utilities VV
TOTAL $ 00*
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
�p THIS BECOMES A PERMIT.
SEPA Checklist ,�--/.2. —$ ///p/ ry ``��
f5ra ¢ _ DATE OFFICIAI / a"prLC - -
H"°`''``o`s'.•. ' ` APPROVED FOR ISSUANCE _