1980, 03-25 Permit: 80-2651 Remodel PLAN NUMBER APPLICATION/PERMIT
PERir11 "',. h sBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT go_ .2 651
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
MI
JOB ADDRESS V 2 * * 4 q, 0 0
1. �' jX�0 ���� LEGAL DESCRIPTION — SEE ATTACHED 4 0 0
LOT BLOCK SU�BC IIVIISIIO.N PARCEL NUMBER/S rAi-2D�s�-a — 7 * ~
2. NER 4. .A r "A1JQi a PHONE /�.D�' /" 0 90.Z �1�,0 0 c0i
nn L3LKz E * 000 8
3. � .)"�iiuP, Pd 4c.,E.YS ADD
'ADDRESS
ZI Actual Set Backs in Feet ' 2 6 5.0 2
iffed6 C?_ .e... Atm 9/9D27 North (South East IWest 0 3-2 5-8 0
C TRACTOR PHONE Size of Parcel, Zone Classification
4. ,2.LuLL- . .. 1.4.C/i <.--3-g'k/2 /35 x 48'0 (414c ,,f/ < mud.. a 6 4 7 9,
ADDRESS (� �D ZIP Type Const. Occupancy Sprinklered
.e /0-,54 /" .c/, 992.0-2_ ❑Yes ❑No ❑ Req'd.
DESIGNER /
PHONE Valuation
Building Area in Sq. F . 3 ,D
a4=24, ( D
5. ADDRESS L ZIP Main Floor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO
Area of Decks Finished Basement Unfin, Basement
6.
TYPE ❑ No. Baths No. Stories No. Rooms No. of Dwellings
NEW ❑ ALT. 0 AD'N. 0 RPL. 0 MVE. /
7. OF OTHER /
WORK ❑ BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
, ,(�/, , of EXEMPTION X
D SCRIBE WORK Enum. Dist. I Location (Area) r
8. �.Zg4. DX — ��� J, ?y 44.14 J I FEES COLLECTED
ALUATION SOURCE GAS ELE RIC WATER SEWER Ownership USE CODE
6.,5�D 0 aG UTILITIES �S/pt e Public ❑Private I ,
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 # _
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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 INSPECTION Plumbing
DATE OF APPLICATION -A-2 5-R D SIGNATURE OF APPLICANT • - - /�/ '
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE 41 Plan Check
Env. Health
>-
Planning fe.,"'� .�..G t. DC7 SEPA
O
U
Fire Marshall -
i� ?1 Mobile Home J
Co. Engineer Other (Specify)
Utilities
TOTAL $ ',1412—
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Build��ing Tec nicia PERMIT IS NONTRANSFERABLE G * ,T i G 2 i---j-
uiQ
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL