1980, 05-10 Permit: 80-4599 Damper PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER 1
SPOKANE COUNTY - BUILDING CODES DEPARTMENT 450- CIq
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
�I* , 4. * 7.0 C
LEGAL DESCRIPTION — SEE ATTACHED , u-
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 7, 0 0 Y
2. n
3
OWNER PHONE E v, 0 �l l,, �'
6Ger 0,___LL cl .,2"441- 4 ;- 9, 8.;r-ADDRESS 7 4 110 — (S I a!1 6 North Required Set Backs in Feet
�... L "1: !.� South East West 0 !-)- 1 C-8 0
CONT ACTOR PHONE Size of Parcel Zone Classification
62
4' AD RES_,S.....
0_ l 1 lJ )/4-l) - Ii l 1 Type Const. Occupancy ❑Yes ❑No Sprinkleredl
Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage —
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER -
WORK 0 BLD. 0 PLMB. 'a.MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRI E WO�R'PC
8. 3J I of( F - e A {I Ape v-, FEES COLLECTED
VALUATION Source GAS il ELECTRIC WATER SEWER
of
9. Utilities x 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
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. 7.:.,:e(
^ Plumbing
DATE E �� SIGNATURE /_ 1/4714:121 ) Mech. �O--'
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
SEPA P
Planning _ w
a.
Mobile Home rn
Fire Marshall
Co. Engineer Other (Specify)
Utilities TOTAL $ 7' o-
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /� j�y/g J�/{)y THIS BECOMESAtPpERMIT. (� (� 0 7 (' O
DATE iIoL�Y7t 2 OFFICIAL ■ V i ��1./Y0 5.!--1,O. (] 0 �t- 7, 7 Z k /, U U d F-
APPROVED FOR ISSUANCE _