1980, 10-06 Permit: 80B-1476 SidingPLAN NUMBER
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c///s7 J
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
LOT BLOCK SUBDIVISION
OVER '/f
3 tt, L : K2i�/! 4 /
ADDRESS
/9R /-4
CONTRACTOR
Po Ua,y er'ofler -
4
5.
PHONE
9a? �334L
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
o?35/i
ADDRESS
ZIP_ yos
PHS,/O/N E
f 2
AL,3 AriOnfv.. /'cWot—
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TO
ZIC
9x06
PHONE
ZIP
Actual Set Backs in Feet
North South East (West
Size of Parcel
Type Const.
Occupancy
Valuation
741/6 41-)
Main Floor
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Upper Floors 1 Garage Area
Area of Decks
Storage
Finished Basement Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
OTHER
No. Baths
No. Stories
ESRIBE.WORK
� i y
tVALUATIO
9'
SOUR
OF
UTILITIES
GAS
ELECTRIC WATER
SEWER
CERTIFICATE
of EXEMPTION
Enum. Dist. 1 Location (Area)
No. Rooms
Req'd.
No. of Dwellings
Recd.
Not Req'd.
Ownership
Public ❑ Private 0
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 regulating construction or t
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building Technic.ID
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABL•
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $‘g, Of)
PERMIT NUMBER
02* *6500
*68.00
*68.006
A *0.00
14'7.52
10-06-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'1 0 -j 6
DATE ISSUED
1'47,654*68t_g_gg
PERMIT NO.