1980, 01-11 Permit: 80-0114 Garage PLAN NUMBER _ APPLICATION/PERMIT PERMIT NUMBER "-----1
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 0/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
. 2 * * 4400
JOB ADDRESSLEGAL DESCRIPTION — SEE ATTACHED * u. 6,Q 0
OT BLOCK SUBDIVISION I �t PARCEL NUMBER/S 176-1 -0103 * 4 4;0 0
2. I I *I;N K-r-r FI s AVP,
OWNER PHONE E * 0 0 0 E
Required Set Backs in Feet
ADD(2•SSI5O, JN,ivks ` C2-2` Co North 23 'South East '35 'West 0 1 — 1 1 —c80
CoNNNTRACTOR 'j Y' PHONE Size Size of Parcel Zone Classificati n
4. M /1 10 x 15(5 /"I�'1� ��e, a 6,4 7 9.
ADDRESS ZIP Type Const. Occupancy Spri lered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Buildingea in Sq. Ft.
5. 6 2 o0 �2,, -
ADDRESS ZIP DWLArea I Basement Area Ga�a�0AreaStorage�� )
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
,,.,// No. Baths No. Floors No. Rooms Rec. Room
TYPE LI NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
7, OF / ❑ OTHER
WORK Er BLD. 0 PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
D SCRIB WORK
•
8 1 p„�,_Y^ �� 6 C3-.21- x al + I,y� �r� FEES COLLECTED
VALUATION V,(/ Source GAS ELECTRIC ✓CATER VSEWER
of
9. 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 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 regu 'ng construction or the
performance/of construction. Plumbing
DATE / !i — 0 SIGNATOR Mech.
SPECIAL APPROVALS SPECIAL CONDITION'S:
& ALli +V-rPlan Check
DEPT. REQ'D. RECD.Env.Health iJor A I Kala SEPA oPlanning KKer7 7-, ftw orfilpai .- "-, r.,eli
f%fJ
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Fire Marshall 91 PAZ'0, -90 L14/ /r1s� t r- Mobile Home ci)
—
Co. Engineer rizo—y` i( .J or reol ' I Other (Specify)
Utilities I�git..fU► `� ‹,J(� I I
• TOTAL $
AL
Zone Clearance .1.-et i Nio Nnivrif
Ilk - c-tr iso,) WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist �. THIS B COiM ?A,pE,BMIT. /� (n�
DATE 7/�.JJ O IAL A�16•P' --""----'2-' �J ""_� U t! �,`t Z *4 �; J 4. J
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