1980, 05-14 Permit: 80-4730 Residence PLAN NUMBER
,L � APPLICATION/PERMITMIT NUMBER
.11 7.30
a/lC�
7 �fl�x� SPOKANE COUNTY — BUILDING CODES DEPARTMENT
to--- f. NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 5--/5--/All ,� )/ -
L� APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES * * G 0
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED * 2 5;:5 0 0 7)
1. N, 12,04 WftRRE4I Rok7
LOT BLOCK SUBDIVISION PARCEL NUMBER/S PTN of /4541_, a 737 * 25500
2. 1 1 IZ1- )tJE_ NDDI.rnoN i 't-LAZ- '/s9 E * O C 0
OWNER PHONE a7lla
3. J/�czasi N co N S7 IZ i tc.—n ON i NC.. y.2'-- 4 7 2.9 r�
ADDRESS ZIP Required Seen Backs in Feet1
4-02.I =. BOONS /aL'F SPbttCAiyE 9 2 1G North 7 I 'South J`J i East 30 'West 82/ 0 5- 1 4-8 0 ‘Ni
CONTRACTOR PHONE Size of Parcel Zone Classification I:\
4. SAMS 12,5o 'x I/2 1N6-i--E.. FAMIL' L2 6.4 7 9.
ADDRESS ZIP Type Const. Occupancy Sprinkleredl
N -? ❑Yes ❑No ❑ Req'd.
il
DESIGNER PHONE Valuation DO Building Area in Sq. Ft.
5. "Y-3�D5-6-5C)( /5-% _
ADDRESS ZIP DWL Area Basement Area Garage Area Storage
/one /008 ..5;z8
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6. ,_
X —
TYPE ���� No. Baths No. Floors No. Rooms Rec. Room
3,..n-
EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. I I if
7, OF ID OTHER
ICERTIFICATE Req'd. Rec'd. Not Req'd.
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. El POOL
of EXEMPTION 1---
I
I DESCRIBE WORK
8. R i PEACE— 6754tR (iE- A-�-I-ACHEu fJ CK A T7'�CI-I j� FEES COLLECTED
VALUATION Source GAS 1 ELECTRIC WATER SEWER
of
9. Utilities
rA Sip 1 /r- Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included 0
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building '255 X
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
Plumbing "'
performance of construction. / -
DATE '' & 4 } SIGNATOR �I IL !� g"G% Mech.
SPECIAL APPROVALS SPE, f CONDITIONS:
DEPT. REQ'D. REC'D. . -$bi Plan Check
Env.Healt1h�
/Talo%e 2/0 0 OIL ON F/i /0 -1 2 'eo SEPA 1-
Planning ON Mk? i — LL
0.
Mobile Home c
Fire Marshall _
Co. Engineer Other(Specify)
Utilities TOTAL $.,5� yx
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECPMES,�PERMIT.
DATEZ�)) ♦ OFFICIAL4a/ itgagi .,
APPROVED FOR ISSUANCE
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