1980, 12-18 Permit: 80B-4951 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT BER `�
SPOKANE COUNTY — Blsr°. :FIG CODES DEPARTMENT
(
) NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
Job ODRESS LEGAL DESCRIPTION - SEE ATTACHED 0 4 * * 1 2,0 ►,
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 1 2. 0
2. * ' ',00Z_
OW R. PHONE
3. ine,/eO .A.,�2 c- A 0 0 P
A7 DR /�U7', ..,/��� , ZIP/,9�-,�� NorthActual Set Back!Sout in Feet East (West 9
� GC/'Z /[/ 4 5,0
C• TRACTORPHO E Size of Parcel Zone Classification
� •' ,9--ioi7 1 .- 1 7- : 0
4' /,D2RESS x ///7- ) ZIP��IQ ^/ Type Const. Occupancy Sprinklered _.. 64 7 9
W. c%td/3 .(l�ic te-c,.S�,Gt-e. / /90/ Dyes ❑No D 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 D IV17iv� I K/
6.
No.Baths No. Stories No. Rooms No. of Dwellings `^l Z it--k9'�1(� '' 7- 0''
TYPE I NEW ❑ ALT. 0 AD'N. 0 RPL. 0 MVE. �'�J ��J `
7. OF �� ❑ OTHER - v
WORK
0 BLD. 0 PLMB. I= MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
D RIBE WORK Enum. Dist. I Location (Area) T
8 {�� �� � e- /X.
�� FEES COLLECTED
1(11)-- liP-Ctj--Ar---'
VALUATION
SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public ❑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 construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS . Plumbing
�
of � U
DATE OF APPLICATION A'24 d SIGNATURE OF APPLICANT 4 � Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA >-
0_.
Planning
CJ
Mobile Home w
Fire Marshall J
LIZ
Co. Engineer Other (Specify)
Utilities } "
TOTAL
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
' B • ing Te hnician PERMIT IS NONTRANSFERABLE _ 7h!•"� + Op. H
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATA'Ici •L " r.'8 PERMIT 4i19.9'•.5-1 *7, t4