1980, 04-25 Permit: 80-3965 GaragePLAN NUMBER
/2-46k,
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 611 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1.
LEGAL DESCRIPTION - SEE ATTACHED
2.
LOT
12,
BLOC
'(0
3.
4.
DWNE�
ADDRESS 4
CON�TR TORI
ADDR5��� \INAM _ 1 1
DESIGNER
SUBDIVISION
‹-rre,A4LI M2r)11
PNE= 37-T?
PARCEL NUMBER/5 5,s� I -/ 7
5' ADDRESS
ZIP
Actual Set Backs in Fee I f�
North 'South 4� East Io IWest 1 `�
Size of Parcel Zone Classification
;oa x j�v R1,710• N1. 4
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Type Const.
Valuat' n
7700
Building q. Ft.
ZIP
Main Floor
Upper Floors
G�gg Area
r
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
Area of Decks
Finished Basement Unfin. Basement
ErNEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
0 OTHER
g/BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not
8.
9.
t2 rk9 &V
DESCRIBE ORK
6 tY
GAy
VALUATION
SOURCE
OF
UTILITIES
ELEC 6YIC
WATER„
G0M0
Enum. Dist.
ILocation (Area)
SEWER
Ownership
Public ❑ Private 0'
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 constru ion or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS i—
DATE OF APPLICATION a �/ Q
0 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
Torn 'O slaw -
SEPA Checklist
ing Technicia
SPECIAL CONDITION(S:
Cgill UAC 2 3 .. 01 sl1 • r4e7 it 2 13
I2-17-0/50)
Mit -TO cofrv-r-fsfeine,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $/Q
Building �Cl
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
rERNI�IVI iE75%OT
J.r
02* *6800
*6800
*68006
E *000 g
381.8g.
04-22-80
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'4'--25
DATE ISSUED
596.52 *68.0'0° -
PERMIT NO. TOTAL
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