1980, 11-18 Permit: 80B-3881 Wood InsertPLAN 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.Z51� rx4We�sc Ro. LEGAL DESCRIPTION -SEE ATTACHED
LOT BLOCK SUBDIVISION I PARCEL NU- ABER/S
2.
OWNER
3.�fi"NDCE
ADDRESS
S. '251 -7
CONTRACTOR
L�9, Nim
4' ADDRESS
DESIGNER
5.
V4'
RIO -
PHONE
;7zy-8/e,z
ZIP
9 -?Zea
PHONE
ZIP
PHONE
Actual Set Backs in Feet
ZIP
forth South
East West
>ize of Parcel
Zone Classification
CHANGE OF USE FROM
TO
Type Const.
Occupancy
Sprinklered
I
Dyes ❑No ❑ Req'd.
✓aluation
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPERPL. MVE.
KNEW ALT. ❑AD'N. ❑ ❑
�, OF ❑OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd
1:1 BLD. ElC�IPLMB. MECH. 1-1 M.H. El POOL
WORK
of EXEMPTION
I
DESCRIBE WORK Enum. Dist. Location (Area)
8 �� / /�
FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF Public ❑ Private ❑
9. UTILITIES
I I
Single $
1 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
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 INSPECTIONS
Plumbing
d a C �
o �i?L� /c�GG%
� c�
Mech. 4
DATE OF APPLICATION SIGNATURE OF APPLICANT,,
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Plan Check
Env. Health
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Plans Examiner
echnician PERMIT IS NONTRANSFERABLE
PERMIT NUMBER
/% goc3-389r
04* *7.00
*7,00
*700
0
11-18-80
ef 6,479.
TOTAL $ 7. 0a
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.