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1980, 11-06 Permit: 80B-3370 ReroofPLAN NUMBER ( APPLICATION/PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 1. JOB ADDRESS LOT 2. OWNER 3. ADDRE 5. APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 6 7// 3 �-u BLOCK SUBDIVISION CO ACTOR, SS ,er as DESIGNER ZIP PHONE LEGAL DESCRIPTION — SEE ATTACHED PARCEL NUMBER/S i " 3/ _ Gel 6. —9 / ., Actual Set Backs in Feet North (South East (West Size of Parcel Zone Classification ZIP_y PHONE Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. Valuation /7,570�o Building Area in Sq. F ADDRESS ZIP Main Floor Upper Floors I Garage Area Storage CHANGE OF USE FROM 6. TYPE 7, OF WORK TO Area of Decks Finished Basement Unfin. Basement ❑ NEW ❑ BLD. ❑ ALT. O PLMB. O AD'N. O MECH. ❑ RPL. O M.H. El MVE. 0 POOL OTHER DESG E WORK 8. No. 681hs No. Stories CZ -44 -No. Roor7n No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. Enum. Dist. I Location (Area) VALUATION 9. SOURCE OF UTILITIES GAS ELECTRIC ATER SEWER Ownersh ip 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 INSPECTIONS DATE OF APPLICATION /l— CPO SIGNATURE OF APPLICANT SPECIAL APPROVALS NAME DATE Env. Health Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist Building Technician SPECIAL CONDITIONS: Ze_Ae,x— q PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ PERMIT NUMBER 7°L —3370 33682 11 8p 64 9. 02* *29,00 * 29,00 * 2-9.006 A *0.00 33692 11-06-80 z 6.479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 11; fl it tlo. DATE ISSUED 357.05 *29.00 O J n.1- - PERMIT NO. ICTAL