1980, 09-19 Permit: 80B-0507 Insert PLAN NUMBER PERMIT NUMBER
APPLICATION/PERMIT 0
SPOKANE COUNTY — BUIL6ING CODES DEPARTMENT G
ei NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 04 * * 7. 00
1 1192 OM1 Li V'J LEGAL DESCRIPTION - SEE ATTACHED
r, r ti:
BLOCK1sC
SUBDIVISION PARCEL NUMBER/S �_ u;
2. * 7, 00 L4:
OWNER PHONE
3. 1 - •--1 Li 14 -i 54-- 4— A ,', C, i 0
ADDRESSP Actual Set Backs in Feet
c". 131 --rtA orK LAN6 7,03 I 5 h
�, r North South East West
CON CT R PHONE Size of Parcel Zone Classification 0 9- 1 9-8 0
4' ADDRESS ZIP Type Const. Occupancy Sprinklered 6.tL 7 9.
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPENo. Baths No. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. ❑ A}�N. D RPL. ❑ MVE.
7, OF —/ ElOTHER
WORK IDBLD. ElPLMB. L`�MECH. I=1M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORKo f I Enum. Dist. Location (Area)
8. 1/\491/\49P� I C� � i FEES COLLECTED
1
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private 0
/ 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 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 cnstruction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTION ) Plumbing
i CV
DATE OF APPLICATION r•O 100 SIGNATURE OF APPLIC (C__;/ve -04.21- Mech. �J
/
SPECIAL APPROVALS SPECIAL CONDITIONS: 7
NAME DATE 1.f Plan Check
Env. Health
SEPA
Planning .r-];
— +,,J
FireMobile Home -J
Marshall
i --
Co. Engineer Other(Specify)
Utilities TOTAL $ >1i• 0 0
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
.ing ' - ni i.an PERMIT IS NONTRANSFERABLE U 90-.1 9,` 3 'r_{ 5 a7 . * 7, 0U t1 H -
-.� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL