1980, 04-22 Permit: 80-3770 Addition PLAN NUMAER t- APPLICATION/PERMIT �PE.:P." • NUNracR
63� SPOKANE COUNTY — BUILDING CODES DEPARTMENT �� �a`�
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS O Z * * $ 0 0
1. ,5'. I 11 7 ki6i. 1- � LEGAL DESCRIPTION - SEE ATTACHED * 8 6 0 0 n
LOT BLOCK SUBgIV!SION or H i419 PARCEL NUMBER/S 3406,43 - of i�p.4917. * 8 6 0 0
2. I ff�Y ffVI 19'ii('JIJpIJI�
owlvl 10' I-1AI1N. TT._ER
E * 0 0 0
3. ADD ESS11/ �1►I,►�/; .,� 11—�J�TJ Actual Set (Backs in Feet / 3 7 6.9 2
�� 1� 117 •V �" ✓'' _ i5.9....2_
� North Y (South ® East I Y? IWest 0 4_2 2_8 0
CONTRA O ✓, PHONE Size pf Parcel Zone CI ssificationV� V
C� IA, w'7 �I� LK rAM . 2 6479.
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
V-hi 2,_-3/1+4 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation 7 Building C a in Ft.
5' ADDRESS ZIP Main Fl or Upper Floors Garage Area Storage -
/L' ��77//.,
CHANGE OF USE FROM TO Ara of Decks Finished Basement Unfin. Basement
— —
6. —
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
❑ NEW ❑ ALT. AD'N. 0 RPL. 0 MVE.
7. OF ❑ OTHER -
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
8 DESCRIBE WORK d (141o,9)
: Enum.Dist. Location (Area)
� � FEES COLLECTED
VALUATION SOURCE GAS E RIC WP1TE SEWER Ownership USE CODE
OF cL)N1t 1 G !
9. UTILITIES � ''�' ��v Public 0 Private
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 r
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
V DATE OF APPLICATION 17 -- /7 - 0 SIGNATURE OF APPLICANT �7/1141"--- Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health 44 �
' -� .,.x d�IM1�tiD SEPA ,3
Planning
�J" ( (3
-
Fire Marshall Mobile Home u
Co. Engineer Other(Specify)
Utilities ,
TOTAL $ 4 w
Plans Examiner if
Aj*
7'OM POS LEvJr LI/0f`0 WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
k(ding T ician r PERMIT IS NONTRANSFERABLE U 4 -2 2 8 0 5 7 7, 0 °z * R., 6, 0_-0 a 1= -
or PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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