1980, 02-01 Permit: 80-801 Addition PLAN NUMBER PERMIT NUMBER i
, � APPLICATION/PERMIT - 3C \
.+ SPOKANE COUNTY BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 02 * * 1 64.00
12-1 7— LEGAL DESCRIPTION — SEE ATTACHED
* 164.00
LOT BLOCK SUBDIVISION PARCELNUMBER/S .2.1541- 1309
2. o o J rl 1—ry s/� o , s2. 0' 1
1 0.4.c, * 164.006
OWNER PHONE
3. A1'LMJ o 4 E * 000
ADDRESS calk ZIP Required Set Backs in Feleet,�1 �f (� 1.9
5'- I2o�( 6- `a s. North 'South i0 East ! 'West
CONTRACTOR PHONE Size of Parcel Zone Classificati n 0 1 —21 -80
4. r)aLN p �✓�16{ v I - 75X 3o0 iIia-16 1-11- 2 6.479.
ADDRESSc/� ZIP Type Const. Occupancy Spri lered
7U.., i 60' 1\10 r t \i–N R.-3 Eyes ❑No ❑ Req'd.
DESIGNER 4 PHONE Valuation Buildin Area in Sq. Ft.
P.+ o o c0 '�9 -
5' ADDRESS ZIP D Arela 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 ❑ ALT. YJ AD'N. ❑ RPL. ❑ MVE. f 1 3
7. OF / ❑ OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK (g BLD. ❑ PLMB. [CI MECH: C7 M.H. I: POOL
of EXEMPTION 1�
DESCRIBE WORK
8. A -ao, I -10 n/ ` ✓�,1'n 0106
G FEES COLLECTED
VALUATI N N Source GAS R1 ELECTRIC WATER SEWER
of
g, . -'el") so OO Utilities
Single $ r
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
il-
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 regulatng construction or the
performance of construction. �\ Plumbing
DATE i —a I —�V SIGNATURE A.latt -(9• Mech.
SPECIAL APPROVALS SPECT L CONDITIONS:
, _
DEPT. REQ'D. REC'D. - P ry(VL Pitt( KI
/ f Plan Check
Env. Health p6f4j ��AlW/ 02.2/6'if
SEPA `�
Planning w
rt
Fire Marshall MAi I, --lb G01-'"r -T-c7 Mobile Home `n
Co. Engineer Other(Specify) ,i
Utilities '&
TOTAL $ I
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist PlAµs G)t THIS(BECOMESA�I E,RMIT. p r
DATE I�ZZ�0OFFICIAL LCL J � v LLI, .L �' * 164, �� t! 1 '--
APPROVED FOR ISSUANCE _
1-6,2‘.6]
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V
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