1980, 05-02 Permit: 80-4247 Remodel ,PLAN NUMBER APPLICATION/PERMIT rPERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT I gd- 47
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED 0 2 * * 3 2 5 0
*
LOT te /6 .2
OCK`" SUB IVISIO PARCEL NUMBER/S 3 2.5 0 u7
2. AA /2A, 'ox .F� of-,� IF ,[i Li 2S-2.1 * 3 2 5 Q 6
Q�/�y�,�//NERr� ,../ PHONE E n
3. f2ADp't''r •.7 ',a a4i / gZ41_. ..5-,e39 ESS ZIP Actual Set Backs in Feet • * Q 0 0 8
�/�� ,(�/ J/� 424,6
-1-d 1,5 17, ./q,etit �.�43d• DU�Ih�L�1 C17eZ/4 North 'South EastWest
CONTRACTOR C PHONE Size of Parcel ` Zone Classification Q 5—(Jg2—8 Q
4. .a444_p 2 2 4 X /6 dGSL.
AQ,DRESS ZIP Type Const. Occupancy Sprinklered 2 6 4 7 9,
,RQy�iy,,,�i,� Oyes ❑No D Req'd.
DESIGNER PHONE Valuon Cr4 Building Area in Sq. Ft.
5. d'O d g,71�/
ADDRESS ZIP Main,/oor 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 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF AI OTHER -
WORK
0 BLD. 0 PLMB. 0 MECH. ❑ M.H. 0 POOL„ CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION )(
DESCRIBE WORK/ , Enum. Dist. I Location (Area)
8. .. 1/(1i �' � /Jeg _ �J.// Q /'.110—L �i , I FEES COLLECTED
VAL ATION SOURCE( GAS jyI ELECTRIC_ WATER SEWER Ownership USE CODE
OF
9.i aZW•1r UTILITIES Public 0 Private & Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included e) _
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building Z- a
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.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION y (J eSIGNATURE OF APPLICANTL` �`- 0-/1/)LLA-/ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health .747i4441+1 R
SEPA r
Planning CD
']� ��/�, ��`"]� �,, (/- a
i` `" %r a. - ��K-444- 4'44/ 4.4/`4iG(il / Mobile Home - w
Fire Marshall n}-�,'�z _' _ J -.-4
Co. Engineer ..�/V// �1� ','/j/.j! Other (Specify)
Utilities `�' rL��` � 'chd �, — e
TOTAL $ �� �
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician PERMIT IS NONTRANSFERABLE 0 5;=0 2'-. 0 4 2 4 7 o *3 2.5 0 o F
66-- a-Yd PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL