1980, 01-22 Permit: 80-455 Repair Fire Damage PLAN NUMBER APPLICATION/PERMIT 0 PERMIT NUMBER
SPOKANE COUNTY - BUILDING CODES DEPARTMENT �y�" `�
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /—fid - l)
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
02 * * 32.50
JJOB ADDRESS , l LEGAL DESCRIPTION — SEE ATTACHED * 3 2, 5 0 b3
LOT BLOCK SUU B I JISION PARCEL NUMBER/S * 3 2 .5 0
2. E * 000
NER PHONE
3. - == �-1_, ,..Li .4 At_' . D ,D/li1 4. 5 4
•DDRESS ZIP Required Set Backs in Feet
11 p t -' / ,-}.a f Alas-iC?.er.Lr,2_ qqa/lo North 'South East (West 0 1 —2 2—8 0
�QNTR CT R // PHONE Size of Parcel Zone Classification
�(�/j( 9— • ' 924—#Cg1 -2 6.4. 7 9,
4' ADDRESS /J�� �(Q� ZIP Type
/ Type Const. Occupancy Sprinklered
r /D 6h D,S /�4 Ckl-ci ,JK� .9 ze4, ❑Yes ❑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. ❑ MVE.
7, OF Z OTHER
WORK ❑ BLD. ❑ PLMB. ❑ ME H: ❑ 0 POAL CERTIFICATE Req'd. Recd. Not Req'd.
lv�� .r. .a of EXEMPTION
DESCRIBE WORK
8. � �Nf A 4--.1- 1� 1e J��f FEES COLLECTED
L ATION Source GAS ELECT IC r WATER SEWER
9. 65
'> p GHQ.D Ut orties J Single $
g —
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 3 z'�
type of work will be complied with whether specified herein or not. Th- • of a permit does not presume
to give authority to violate or cancel the provisions of any other st.r r ..<I la I regulati.g construction or the
performance of construction. I \ // Plumbing
�
DATE / —.2.2— FD SIGNATU-/ 11!LIiI /JL Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. ^,AIC/4..f )K Plan Check
Env.Health
,flri�2't az_.' .1��.12/F"w' _ 4244 I �il.e�4%I
SEPA r=o
�/�,('� I l--
Planning Widt'"'__— I r -- w
CL
/ Mobile Home z
Fire Marshall n AAY e, _ w
Co. Engineer �Ak\' ta.' .-'"�'!nE /C/N,7� Other (Specify)
Utilities 6'0
TOTAL $71 .- ,-
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist _ ��n�,,� ,[/� � j� THIS BECOMES A(PERMIT.
DATE 2 — �D OFF ICIAI,iiab"'►"i dal'i. w"i �f -`L'2 - U CI f J, 5 ?: * J L. L
APPROVED FOR ISSUANCE —