1980, 07-18 Permit: 80-7377 Residence PLAN NUMBERAPPLICATION/PERMIT F'EF:;VIIT NUMBER
2' 02 '°_ 7377
BUILDING CODES DEPARTMENT
i I
SPOKANE COUNTY —
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
k , ;
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1. e. 7 4) girl, L meq'...
LOT BLOCK SUBDIVISION A PARCEL NUMBER/S4724K5-,-1 '/,-4)L� ;�
2. *�� 5 '317-6--!-- /7'�.( -C f� /4.4;&' k-ti L.f2:(-44-;4-' �
./....07--v^ r !
OV)(NEft PHONE - *'
3. c-iii�• % ?'1 -L.Jrc.&.1-- A,,,,t—, . 1 i‘,t---157 ';" l�!iI 0 a kJ V '1 a(
3
ADDRESS -
y 'i yf6 / (� S ZIP Actual Set Backs in Feet ;
Y/t /js-T-✓,: 'J 4t .1c r �t0 /-t _ g •ZIF Norths3,-)- 'South j q✓ East .! 'West U r? ,_
CONTRACTOR PHONE Size of Parcel Zone Classification
a `
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
',.(t,-(1,,,i (..i ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation� `o/�
+3' Building Area in Sq. Ft.
5. x._51 > f.�._ 412)/2,
ADDRESS ZIP Main Flbor Upper Floors Garage Area Storage —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. ,8/-, -.4 i
TYPENo.Baths No. Stories No. Rooms No. of Dwellings
❑ NEW ❑ ALT. 0 AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER / I - �
WORK '
0 BLD. PLMB. CIMECH. 0 M.H. 0 POOL CERTIFICATE Req'G. Rec'd. Not Req'd.
of EXEMPTION A
DEWRIBE WORK Enum. Dist. I Location (Area)
8 I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
y ,qVua- OF
• _J[7...!)--,=7,-.',:',/•`•- UTILITIES Public 0 Private X
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included 4J _
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this 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 4---er'iv SIGNATURE OF APPLICANT — if d/�� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATEf
. . Plan Check
11
Envt, � y .nt" `7�;'I!.` �-
✓; I 7/8) (/%/�� �4- SEPA
Plann . �f ... ���y�'
t 1i�s"alldd‘,..2.7.,'� D� Mobile Home i
i.
Co. Engineer Other (Specify)
Utilities ;]
TOTAL $ -f.='
Plans Examiner
—Mkt 1'0 kt(Alkr 7)l8lx�;. WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Bu ding Tec niciain s PERMIT IS NONTRANSFERABLE +1 .o —
J �� �a��e PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT~Ne • / * 2 i ,,.TOTAL;-
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