1980, 09-30 Permit: 80B-1159 GaragePLAN NUMBER •
-41^-
APPLICATION/PERMIT
eg3c;18o SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
JOB ADDRESS
3t -
LOT BLOCK SUBDISION
LEGAL DESCRIPTION - SEE ATTACHED
NER
3.
ADDRESS
C -."–T/ <2 gir CGS .SZji4.(1)
CONTRACTOR
4. ADDRESS
PHONE
5,5-3 y4";
PARCEL NUMBER/S `-5"3/_,
iv ,c..o r is' .431-K /
A,/ A/8" ADO; rjdN
ZIP
PHONE
Actual Set Backs in Feet
North 6/7' ' 'South ! East i-2 (West/
Size of Parcel
ZIP
Type Const.
Occupancy
Zone Classification
o, . Iia i < •17./1
Sprihklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Vivation
\5; fr40e
Main/Floor
Lii5/
Building Area in Sq. Ft.
Upper Floors
&dG
Garage Area
Storage
TYPE
7. OF
WORK
NEW
❑ BLD.
❑ ALT- ❑ AD'N.
❑ PLMB. ❑ MECH.
❑ RPL. ❑ MVE.
0 OTHER
0 M.H. 0 POOL
Area of Qecks )Wished Basgment
�j 4®4 �I(%1J(_(�
No. Baths
c�—
No. Stories
Unfin. Basement
No. Rooms No. of Dwellings
1
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
SCR E WO K
1,4
Enum. Dist.
Location (Area)
VALUATION
;aa
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 constructtiion. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS J
DATE OF APPLICATION / �.Z-! �d SIGNATURE OF APPLICANTClt�Q„rj+--../
SOURCE GAS
OF
UTILITIES
ELECTRIC
WATER
SEWER
Ownership
Public ❑ Private
USE CODE
SPECIAL APPROVALS
NAME DATE
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building pchypicianil
4444i 4'ava,tesit,
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
oe
TOTAL $
PERMIT NUMBER
—Ii
02* *5600
* 5`600
* 5E 006
A *coo
115,8-2
09.30-80
647
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'09yr310.38u
DATE ISSUED
1 1 5.9
*56,00°
PERMIT NO. TOTAL
A
1%00 4.5 HFI,
.STG"Aot!AL