1980, 09-03 Permit: 80-9539 Addition !PLAN NUMBER 1 APPLICATION/PERMIT �P CMIT NUMBER" /
(D SPOKANE COUNTY BUILDING CODES DEPARTMENT
2 NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES I
C JOB ADDRESS ' * * 1 i ( 0 0
1. S z/643 E".> �o0;dReif'F �,z. LEGAL DESCRIPTION — SEE ATTACHED . ., C' G
LOT BLOCK SUBDIVISION PARCEL NUMBER/S 1 * p ! n L
2. / / �64�0E2a SJ4 fk/2E 5.
OWNER PHONE Lr
. '* ( (; 0
3. P 4'0/4 //1-1RCRU27 USS/(//--p/6I
ADDRESS ZIP Actual Set Backs in Feet ti
5- -416 0 S" WOOr0R:i'p - North 'South /O/ East (West 4/Q d 0C-03L80
CONTRACTOR PHONE Size of Parcel Zone Classification
4. XIV cam. 5cI-/Rene",OEaZ 4/66-6 7�'Z /20 436 c"' /967P/ S,,a. c
6 I 7'
ADDRESS ZIPp Type Const. Occupancy Sprinklered
G. /R/_,-- eCelxi�2 /IP/�-/gyp Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valua 'on Building Area in Sq. Ft.
5. /c//00 -4d4/c
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
1747/Z-
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. /e
/ No.Baths No. Stories No. Rooms No. of Dwellings
TYPE
12(NEW ❑ ALT. (�AD'N. 1=1 RPL. 0 MVE. i .e..._
a /
7. OF ❑ OTHER -
WORK 0 BLD. ❑ PLMB. ❑ MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum.Dist. I Location (Area) r FEES COLLECTED
8. /T/ca.11 7a exf 5 re's-Li`j /.0ENcE= 1
0,74 VALUATION SOURCE GAS ELECTRIC WATER SEWER
OF Ownership / USE CODE
9 r�% UTILITIES 5,0770 Public 0 Private ler
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 *PO oO
type of work will be complied with whether specified herein or not. The granting of a per it does not presume
to give authority to violate or cancel the provisions of any other state or local law regula In con ruction or the
performance of construction.SEE REVER��S.E_SIDE FOR REQUIRED INSPECT O Plumbing
cj
DATE OF APPLICATION 7 7 SIGNATURE OF APPLICAN T —r— ech.
ECIA APPROVALS SPECIAL CONDITIONS: l�
NAME DATE Plan Check
Enj• -
M --(0S
L, �� IJ-��{�--r2
9 !' ia >--
SEPA a.
P anning C.-C../V"<4./0 U
%� —
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $ HO. oO
Plans Examiner
To V.i plc/L 't,4t't-' r zl?;? WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buildin9.
/Techniiccian PERMIT IS NONTRANSFERABLE 0 9: - '3',-810 9 3 9 o *1 1 0 0 0 o
9A •'94-3
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
,99g
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