1980, 05-27 Permit: 80-5038 Chicken HousePLAN 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
JOB ADDRESS
LO
J
BLOCK SU I IS ON
LEC -AL D.SCRIPTION - SEE ATTACHED
3t' �%l)
ADDRESS -,,rI
.%?-2./ 'rhe# G
COpNTRACTOR
4. _a9 4✓VdLh�
AD9RESS
✓tL
DESIGNER
5' ADDRESS
PHONE
9.24-/3,7/
ZI P
9 ,wad
PHONE
ZI P
PARCEL NUMBER/S g�-1-13
Ls r / 3L # .'
r'F app, ,vromir,%
4 . , 1'
Actual Set Backs in Fee
North 'South
East
West
Size of Parcel
ota Q
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes No ❑ Req'd.
PHONE
ZI P
Valuation
Main Floor Upper Floors
Building Area }n Sq. Ft.
3 7a,
Garage Area
3
7,0
Storage
747/
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
ORK
ki NEW
VALUATIO
9.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
RK /f
SOURCE GAS ELECTRIC WATER SEWER
OF
UTILITIES
❑ OTHER
No. Baths
No. Stories
1
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Ownersh ip
Public ❑ Private IV
USE CODE
No. Rooms
3
Req'd. Rec'd.
No. of Dwellings
Not
Req'd.
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 const ction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIOJIS
DATE OF APPLICATION-T—7—Yd
SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
8 ng�Tec icia
SPECIAL CONDITIONS:
q��
/•
It L'i
41412/✓ N -O� (9-if�'✓uLQ,.2Li'.CO
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
—2 -‘)au
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
moo°°
TOTAL
PERMIT NUMBER
V — ��`)•:f
02* *2000
* 2000
* 20.006
E *0.00
503.7-2
05-27-80
$ 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'0 5,1-2/
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
843 505,85
PERMIT NO.
*20.00°
TOTAL