1980, 04-03 Permit: 80-3063 DemolitionPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
JOB 1 ADDRESS 1 1 141FrIL�
LOT
BLOCK
SUBDIVISION
3
4- ADDRESS
OWNER G, IA14II 21,"
ADQRESS
2x 1zi-zg6 G'oeAn
CONTRACTOR
_5/60,1
5
DESIGNER
PHONE
PHONE
ZIP
PHONE
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S ‘;:,;, _ e757q—
Actual Set Backs in Feet
North !South [East (West
Size of Parcel 40., Zone Classifion
ype Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
6,00
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ ALT.
BLD. ❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
O M.H.
❑ MVE.
❑ POOL
Er -OTHER
No. Baths
No. Stories
J
CERTIFICATE
of EXEMPTION
No. Rooms
No. of Dwellings
Req'd.
Rec'd.
Not Req'd.
DEScRIBE WORK
1-1•101,1110
1JI1 IV!V 1 p c
VALUATION SOURCE GRAS ELECTRIC WATER
9. ID OF
UTILITIES
8.
Enum. Dist. I Location (Area)
SEWER
Ownersh ip
Public ❑Private ❑
USE CODE
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
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
DATE OF APPLICATION °V` "C-2 SIGNATURE OF APPLI
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
�iltling T ician.
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
02* *1000
* 1000 N
* 10006
E *0.00
3062
04-03-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1P4= -03, --TO 3 0 6.3 z * 1 0, 0 0 21 -
DATE ISSUED
PERMIT NO. TOTAL
1
1
1
i
J
1'
r
I I
1 1
r
Y {
4
1