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1980, 05-05 Permit: 80-1812 Repair Fire Damage PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER SPOKANE COUNTY — BUILDING CODES DEPARTMENT 80 ` 18 I2 NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES * * 6h 02 JOB ADDRESS 1 6©,} +1-14 LEGAL DESCRIPTION — SEE ATTACHED 6 i 0 C LOT BLOCK SUBDIVISION PARCEL NUMBER/S ..2.4.5�2 „ / ©w1 , * �., 2 r; �'i': 2. kJ' . I –q- or 6 - �2I ©� N -3©8 of E * 0C .� ONE 3. OG p� L K — I o R P53+"I B7 5 �) �/z p s 5 174- or I•J1/4- D24c. go. 1 8 1. 1 ADD ESS ZIP Required Set Backs in Feet ' +114 72- 6 North 'South East (West 0 3— 0 5—8 0 COCONTRACTOR V PHONE Size of Parcel Zone ClClassssiliic'atio ,_, ItG_ 4' ADDRESS ZIP Type Const. Occupancy L Sprin lered ❑Yes ❑No ❑ Req'd. 4. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP DWL Area I Basement Area Garage Area Storage CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. No. Baths No. Floors No. Rooms Rec. Room TYPE ❑ NEW IE(ALT. ❑ AD'N. 0 RPL. 0 MVE. 7, OF _/� ❑ OTHER WORK �YJ BLD. 0 PLMB. 0 MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd. of EXEMPTION 8 DESCRIBEr''sP'RK 6 C Jle)6 b� 5 If , 1P-) FEES COLLECTED VALLLUj/A��T ON Source GAS ELECTRIC WATER SEWER of 9. -7,-,0Utilities 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 Building 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 eguating construction or the performance of construction. Plumbing DATE 3- I SIGNATUR CI # Mech. SPECIAL APPROVALS SPECIA CONDITIONS: Plan Check DEPT. REQ'D. RECD. ['1-16 ' Ali yln gmt 4��/j� Env.Health 1\i° I i/w 5A1/–r . �i�a z Uri 1� ���"`III`���rJV'� Iw 1:�1 V�– �� � 1 l I Y� SEPA oco f— Planning — LII a. Mobile Home ci) Fire Marshall z Co. Engineer Other (Specify) Utilities /r TOTAL $0'6 NY Zone Clearance \ 1`. WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist a THIS BECOMES A PERMIT. �t r .. , So .. �i 05.4- [j5 '8 `f 18� 1, 2 �' * 68. u �' ° _� Fa�l 'S� 3 ry.�r DAT O- . - i) 11 !-- /e••'iVED FOR ISSUANCE —