1980, 06-23 Permit: 80-6151 AdditionPLAN NUMBER
APPLICATION/PERMIT
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.
3
JOB ADDRESS
13.„069 �- 4114
LOT
BLOCK
1�3
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
o pia6A-riJ►J
ow.
vnet.1 1/16
ADD ESS
2 So -) K ,61--rtk
-0761
PARCEL NUMBER/S ✓ ,j_� — 7 1
vJ , [o o l or 6., 300'f( s N vJ
ZIP
CON RACTOR I
a. G G�1j' I.c
ADDRESS
DESIGNER
5. ADDRESS
PHONE
44? 1007
Actual Set Backs in Feet ./
North (South 7`2
Size of Parcel
1°4 X �3
East
1West
Zone Classificatio
$041aqC
o /
PH NE
Type Const.
Occupancy
Sarinylered
❑Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
ZI P
CHANGE OF USE FROM
6.
TO
Main Floor
[6' 1
Area of Decks
Upper Floors
Garage Area
Storage
Finished Basement
Unfin, Basement
TYPE
7. OF
WORK
❑ANEW ❑ ALT. LJ AD'N.
(g7 BLD. ❑ PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not_ Rev'd.
DESCRIBi2 WORK
8. �i n
VALUATION
9.
SOURCE
OF
UTILITIES
Avorri,AI 14'
GAS ELECTRIC
WATER
Enum. Dist.
ILocation (Area)
SEWER
Ownership
Public 0 Private tilee
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 r ting nstr ion or the
performance of construction. SEE • EVERSE .IDE FOR REQUIRED INSPECTION
DATE OF APPLICATION 6
Env.
Pla
SPECIAL APPROVALS
NAME DAT
IGNATURE OF APPLICA
SPECI CONDITIONS:
Hing
11 €-
Fire Marshall
Co. Engineer
Utilities
3/1°1011)
lAtecKI 17.reivei /450 13-1.- C10•1 WC -1-01
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mec
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PrRAil'NIJMBER
gD
02* *4400
*4400
*44006
B *000 S
607.42
06=2080
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
015ir2 `81)
DATE ISSUED
61r.5.1Z
PERMIT NO.
*44,00a�
TOTAL
uJ
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