1980, 04-22 Permit: 80-3759 AdditionPLAN NUMBER rs
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
LO BLOCK,ijBDIVISI �
. 144441 -�'�
WNER
t^
2. 8'
3.
I
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
6W-79 5'
PARCEL NUMBER/S (z3 3 -Ole) 7
ker 8 J34-1( /
S y MONS A DU i 7/UN
'ADDRESS 1
e
C NTRAQCTO y
4. l./
AZ ADDRESS
e 1/2 c2 , , -444C-
DESIGNER
5.
ADDRESS
ZIP
9gi-C o6.
Actual Set Backs in Feet
North as ISouth
East .;1- ;West /sr.)
PHONE
Size of Parcel
ZI P
Glx/:,77
Type Const. 1 Occupancy
Zone Classification
/raSJJ
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation
ZIP
Main Floor
,
Upper Floors
Building Area in Sq. Ft.
//1--‘Q-1
Garage
�Ar �a
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
O NEW
❑ BLD.
❑ ALT.
❑ PLMB.
AD'N.
0 MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
/
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DE CRIBS WORK
O�J
Enum. Dist.
Location (Area)
RCE
ELECTRIC
L
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
�(J
DATE OF APPLICATION 4-�9-FCJ SIGNATURE OF APPLICANT7��' `� ' ��
S E
OF
UTILITIES
GA
WA ER
SEWER
Ownership
Public ❑ Private IR
USE CODE
SPECIAL APPROVALS
NAME DATE
SPECIAL CONDITIONS:
Co. Engineer
Utilities
Plans Examiner
ToM Pof i LEIA)q-1T 24
SEPA Checklist
B ildi g T chni • neg.�����'/%}-��
OOP F3,4Wiric. P.PPJ. or i -C --VW]
MI Rdei‘R '/4' &66,�i���
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PEftk'.;t NUMBER
7,541
02* *12800
* 12800
* 128006
E *000
375.88
04-22-80
g 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.15, 9 z k 11 o n O a F
0'44- 2 2-'--$8 0 7 / 7 0 U
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
r
_ 4_ -H 4- -
— 4
— —I-
10111'
—sea. S