1980, 08-26 Permit: 80-9133 Addition, Remodel PLAN NUMBER I APPLICATION/PERMIT !p,,,?MIT NUMBER-e,/�� �9,9 I 8/ �8a SPOKANE COUNTY — BUILDING CODES DEPARTMENT
L80 - 9i3
/ •J NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 I
�j APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES * C
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED * 1.) __. 0 n1. e /90 zo 1.z�, C�ic.LP. A
LOT BLOCK SU DIVISION PARCEL NUMBER/S clO J-v,i-,2-Do,2D(® -/ a/ 7 d F , 1 5 2 .2
2. &o r li 8,t r.2.z-(3E*.AT A/E# CO 4,, TN.5.343,7 ..
OWNER PHONE r/'I. SWI-Y 7.5.'Aka.N.LA/DA'/RR. CAneib,( rho_ 0F.-26-80
N. Cale-4311VA/. LN�Qn. ,E.4,g6''7o P4.8.
3. �QLti�(�iG' 4 5'' 7,63 To a.R,6 ,CS 6 4 7 9.
[IAD RESS I/o "y� y// /%_t9 ZIP Actual Set Backs in Feet /
C i9UzO / 4 vl/v'� OiZ��� ! 90�� North�0 ISouth��Q East /6- Iwest. .3
C``��''TRACTOR PHONE Size of Parcel Zone Classification
4' —�
al 0 -- "!J 61=1A4 d.2.) 44G-887/ _,5- S/5 '' .�4... . . / f
ADDRESS
ZIP Type Const. Occupancy Sprinklered
V-N Ig- -3 Oyes ❑No 0 Req'd.
DESIGNER PHONE Va ation Building Area in Sq. Ft.
5. 7 6,30� <200/ App/T/dA/
ADDRESS ZIP Main Flopr I Upper Floors Garage Area Storage -
.204 --
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. —
TYPE No.Baths No4 Stories N Rooms No. of Dwellings
❑ NEW 0 ALT. 0 AD'N. ❑ RPL. 0 MVE.
7. OF ki OTHER
WORK CIBLD. ❑ PLMB. D M H. ❑ M H. POO CERTIFICA E Re 'd. Rec'd. Not Req'd.
V- of EXEMPTION
`�/�,D�E^JS//^�/C?/gpIBE WORK
wY,+yn �� Enum. Dist. I Location (Area) FEES COLLECTED
8 �ALUA SO RCE,A S ELECTRIC�NWAT R SE ER
Q(J
Ownership USE CODE
6,3 a 00 UTILOIFTIES Public ❑Private i( 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 fc...2 -
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
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 4/,,/2 / 14LPlumbing
DATE OF APPLICATION 8-/9— So SIGNATURE OF APPLICANT ��i!' Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Ith
ii—.& /'.`t/ SEPA >-
a.
Planning 0
U
Fire Marshall r
Mobile Home
.-i
ti
Co. Engineer Other(Specify)
Utilities
TOTAL $ 6,-
Plans Examiner D
Ir tVi re)5-7-. m17- 2-6 WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
BUjlding- �-e�hniciy�p PERMIT IS NONTRANSFERABLE �fi -,2,6'd:8.(� 9 l 5 3,c� '* 6 2 O 0 L.
p/(1`!)fA`�/7���`/', "„CeLyirik PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
3
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