1980, 10-31 Permit: 80B-2999 Special Inspect PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
O/3//gd SPOKANE COUNTY - BUILDING CODES DEPARTMENT 8 013^ ���
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
2 * * 800 •
JOB ADDRESS '7 t4-4 a„4<t-e LEGAL DESCRIPTION - SEE ATTACHED
SCOT BLOCK SUBDIVISION PARCEL NUMBER/S * 3 0 0
L
2.
OWNER PHONE Fk CO ER
-
3. Fz-41, o� `7
9,26-//71,3
ADDRESS �/- / { ZIP Actual Set Backs in Feet
1 66.6
C(CC..,td 8�f o -/, '`. L'�L� "50/) 9 ..zei • North 'SouthEast lest 1 0-0 8-8 0
3COTRACTOR PHONE Size of Parcel Zone Classification
,47 4 _ 6 4 7 9.
4' AD.RESS ZIP Type Const. Occupancy Sprinklered
,/a...44.4i Dyes ❑No ❑ 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
6.
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ NEW ❑ ALT. El AD'N. ❑ RPL. NI MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
• L�k�A�' of EXEMPTION
DESCRIBE WORK ? -ate �__ y"" _�y Enum. Dist. Location (Area)
8 I _ .: l # G'--1-11/11---E J� i FEES COLLECTED
V°LUATION SOURCE GAS ELECTRIC WATER SEWER USE CODE
OF In Ownership
9. UTILITIES /1 (2/.40°_, Public ❑Private ❑
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
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on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the 14A/0 % 0
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIO Plumbing
DATE OF APPLICATION la -k-XSIGNATURE OF APPLICAN _ // , ` .«r.'.__J ech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE d ��,( ,J / �j �j ,`� Plan Check
Env. Health 3...u.-e �iw"' ' y'�e--et.�l y n ��i &6"../�.5 ,...t,Le-7�
Planning �1 U /t. � �-"' SEPA n
�//'++UUV�����ll����. r Mobile Home _1
Fire Marshall .E G
Co. Engineer
Other(Specify)
Utilities 6.G2wT�' `"p1 //j/, i ,^ - G1 ,:,z9Q,
TOTAL $
Plans Examiner ,.�,(� �� (%,
���! ���JL WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Tec nicia
l 0'PERMIT IS NONTRANSFERABLE . ;'}; 8!Q; 2 919 9' tir �A QG h
-a ' k= a PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTL