1980, 12-24 Permit: 80B-5234 Fire Damage RepairPLgf`•' t^,,JMEi►R
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
1..s�
LO LOCK S BDI ISI N
2.
OWNER
3.
LEGAL DESCRIPTION — SEE ATTACHED
GLI-
ADDRESS
CONTRACTOR
4. .Cth2lt�
AD RESS
PHONE
ZIP
q i ,6G
PHONE
ZIP
PARCEL NUMBER/S
r9 £L1`.2.2 ,EXC, N.s:q- .
,coria .Exc.
S Rkit gE sr A pirioAt
Actual Set Backs in Feet
North 'South
Size of Parcel
/Od k/.25
Type Const.
East
! I'1`l est
Zone Classification ��77
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
ZIP
Main Floor
BBuiliilgiiinnn Area in Sq. Ft.
Upper Floors Garage Area r/
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin_ Basement
TYPE
7. OF
WORK
❑ NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
ZI. OTHER
0 BLD. 0 PLMB. ❑ MECH. I] M.H. 0 POOL
-
DESCRIBE
_ i n1E^,L2/ .4....fame
- ,k24WC,
V LUATION SOURCE GAS LECTRIC WATER
SEWER
y7.5-ne
°6 UTILITIES
OF
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
No. Rooms
Ret.
No. of Dwellings
Rec'd.
Not Req'd.
Enum. Dist. I Location (Area)
Ownership
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 INSPECT! NS
DATE OF APPLICATION/-/-2f-,5Z) SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bultling Te hnici
4ae o t
SPECIAL CONDITIONS: �J r
X</ti- , ,( " Q -1 -1 -t -i -W - ,R
,f,,t Q.C4- 7 )2tu.G4A.4J
Aeux-, ,P,eIA4tz
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building '/d s
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $/Q
PERMIT NUMBER
02* * 1 0.00
*1000
52332
12-24-80
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1224-8O'
DATE ISSUED
52 4 2
PERMIT NO.
*10:00 -
TOTA L