1980, 05-05 Permit: 80-4305 Pole Bldg PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 80 ' 405--
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 0 2 * * 5000
JOB ADDRESS
1. 17 C®0 7 • ( 'TT44 LEGAL DESCRIPTION - SEE ATTACHED * 5 0 0 0 tii
LOT BLOCK SUBDIVISION PARCEL NUMBER/S /1
I r.2 -te 4 1 9.3 z
2. �OWNER rl .e21%';1211•) -- e• --re, o "ClLo1 S l a A 1-3-5 �- 4/►�IIE . 376 I 0 5-0 1 -8 0
3. ___IPA roi.Er -Iii I ._, lb• 1361 + cc. 16"J
A DDR,E55 /) 6 - 1 `le..��sisr�l 1 Z? Actual Set Backs in Feet Z. 6.Ll 7 9,
`jam � 6. 1�F' 1( p 1 North2- 1,,,
� (South East (West
CONTRACTOR PHONE Size of Parcel Zone Classification
' \?%1 13O .2 0 Al 1546- '
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. F
40 72 - I00,0
5' ADDRESS ZIP Main Floor Upper Floors Garage Area S •r.•e _
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfii. Basement
6. — — l",
TYPE ,_,_,� No.Baths No. Stories No. Rooms No. of Dwellings
LrT NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF / 0 OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not q'd.
of EXEMPTION
DESCRIBE WORK Enum.Dist. Location (Area)
8 C=;�/hC � (rot-p
i1/y CJI ., I_ i ? �.9— I FEES COLLECTED
VAL `�-�1 �/"ELL �`' � T
SOURCE GAS ELE%TRICSEWER Ownership Ownership / USE CODE
OF
9. UTILITIES t/ - ` "vr I " Public 0 Private NI Single $
I hereby certify that I have read and examined this applicatiortiraff hive read the "NOTICE" provisions included 11O
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this 5o,
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 regulating construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION ill` 61—C-.° SIGNATURE OF APP LICA . lr -,.;. _ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE ..�✓✓�� `_'i Plan Check _
Env,(}-I I t'��
c�OZ1"ir�/ 1. , i1R N SII drd r-11 ��
c/� /,/k, I SEPA Q
Planning 1I1\1� "rL� /�WNIr( _ CD
'`�I C. ��VV'`,v� — Mobile Home W
Fire Marshall 'J
Co. Engineer. eilezi /14e, Other (Specify)
Utilities I, 50
TOTAL $
Plans Examiner
L /r l t_dI3/dA WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
•
ui ' g Tech ician PERMIT IS NONTRANSFERABLE 1 0 5 `'8 0 43.0. 5 5 * 5 0. 0 0.2
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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