HomeMy WebLinkAbout1980, 01-10 Permit: 79-54 Insert rANNUTMBER
APPLICATION/PERMIT i,,f �PERMIT
E NU E '
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
11W�`�YW LEGAL DESCRIPTION - SEE ATTACHED * 7, ._, (
LO�� BLOCK� �BDIVISIO � PARCEL NUMBER/S * 7. 0 i
2. -
3. °DoUAt-fl 3ENA E� 129:Zq3 q 5 J g
ADDRESS41
JailE''(AY o fz' to North
redSetBac'South
ks in eet East (West 01 — 1 0 .'' �•-
CONTRACTOR )) PHONE Size of Parcel Zone Classification
4. FON aetST506. 6 4 i 9.
ADDRESS��O� �� �• ZIP Type Const. Occupancy Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7, OF ,/ ❑ OTHER
WORK
0 BLD. ❑ PLMB. ,1r MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. InSTA Fe -Tt3cSiRT' FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
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 regulating construction or the
performance of construction. Plumbing
DAT�/Jtd a SOW SIGNATURc)2$&1.0: !! Mech.
�/ SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
c
SEPA C
E;
Planning — L
r
Mobile Home
Fire Marshall _
Co. Engineer Other(Specify)
utilities TOTAL $ O_�
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE!' 14010 OFFICIAL. 4," 11 ��� 5, 7 ;)
APPROVED FOR ISSUANCE -