1980, 10-01 Permit: 80B-1246 AdditionPLAN NUM1R
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 ADDRESSR1/ C
' "
LOT BLOC CSUBB ISION
LEGAL DESCRIPTION - SEE ATTACHED
2.
OWNER
3 h1, 1344 13,al �r..r�.-
ADDRESS
C9NTRACTOR
DDRESS
.,div 7
DESIGNER
4.
5.
6.
ADDRESS
PARCEL NUMBER/S ..2*J3
PHONE
ZIP
99.2a
CHANGE OF USE FROM
TO
PHONE
ZIP
.LOTS 3 T ,E-,34./ kers
Zkj( .PAR/ -(s ADL
Actual Set Backs in Feet
NorthA%gri ISouth,j 3 East {, (West ' /
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Size of Parcel
9
Type Const. Occupancy
Valuation ti
Main 4loor
Ara of Decks
Upper Floors
1
Building Area in Sq. Ft.
�l`Z2' Dr)/ T/diy
Garage Area 1
Finished Basement
Storage
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
❑ ,BLD.
❑ ALT.
❑ PLMB.
AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
❑ OTHER
No. Baths
No. Stories
I
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCR BE,WORK
8.
VALUATIO''
9.r2dg�;�
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 the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SOUR(JE
OF
UTILITIES
GAS
SEWER
Enum. Dist.
1 Location (Area)
Ownership
Public D Private g
USE CODE
DATE OF APPLICATION 9"" 29"SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Fire Marshall
Co. Engineer
Utilities
n
PES Cm/.C. 7/ ✓�%
SEPA Ch cklist l
Xing ech ician ,(]a
SPECIAL CONDITIONS:
/U -2, -7.4A -N/.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
f
FEES COLLECTED
Single $
Building qg
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
1PERIV'NT NUMBER
02* *9'800
*9800 N
*9E 006
, A *000 0
1245.g
10-0r1k-80
g 64/'9
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
fl
0,-10.1) 124,6'5,
DATE ISSUED PERMIT NO. TOTAL
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