1980, 07-25 Permit: 80-7669 MHPLAN 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
JOB ADDRESS
1. e 7ood-
LOT
2.
BLOCK
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
3.
OWNER
ADDRESS �
E l a t
3f-ashe. sj,p'�
C JTTRRA�C',TOR
4. ADpRESS
PHONE
9zZ-o3��
PARCEL NUMBER/S.4,5 /_02SfZ
FTN, O, 45 3 -2si/
,t..DTS 32 - 3.3 sv I A.dr3/ /3.4.-K
Z.A4P//per /i.E!(cd r.5 140I�
5.
DESIGNER
ZI P
Gg2D6
Actual Set Backs in Feet
North (South a .. [East /c$
West
PHONE
ZIP
PHONE
Size of Parcel � Z e Classificatijon
X / 3 ...za— iJ� i ,.2,
Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Siz
ADDRESS
ZIP
Valuation I Building `Ayrea in Sq. Ft.
1 jc'3i
Main Floor'
�v36
Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
7.
TYPE
OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL. ❑ MVE.
M.H. ❑ POOL
❑ OTHER
Area of Decks Fi ished BaserPent
No. Baths o. Stories/
]/
Unfin. Basement
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIB
8. -14/( WORK
k:cU
WATER
VALUATION
9. 1/CiDDvc
I hereby certify that 1 have read and examined this application
SOURCE
OF
UTILITIES
GAS
ELECTRIC
Enum. Dist.
ILocation (Area)
SEWER
Ownership
Public Cl Private lX
USE CODE
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 7
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env., -alth
PI.nning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Bu ing ech ciao
014-'i
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
#.4._00
Mobile Home —_
Other (Specify)
TOTAL
PERMIT NUMBER
- 76,64
02* *5000
*50.00
*50006
E
*0.00 8
76688
07-25-'80
2 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
ti 71..2 5L8i0
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
76'6.92
PERMIT NO.
*50.00RIr2
TOTAL
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