1980, 12-15 Permit: 80B-4838 Addition PLAN NUMBER APPLICATION/PERMIT IO RMIT4NUMBER
2Q6 /. /"..5780/" / 0 SPOKANE COUNTY — BUILDING CODES DEPARTMENT I go 4-g-1301
l NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
/ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED C 2 * *. 9 8 0 0
1. E i5 Z\ G 'II
LOT BLOCK SUBDIVISION PARCEL NUMBER/S r 0 9
2. 4 t ��'tvt.�S A00, 6 /I -
OWNER PHONE
1 ANN,/ -ot T-M0Iv CIZZ—pct 630 , a35-'44-4.5941 1 2- 0 2-8 0
ADDRESS ZIP Actual Set Backs in Feet
C- iSia. l c, t H ClIc°>3l North 7O' 'SouthEast 3' (west 6 6 7 9
CONTRACTOR PHONE Size of Parcel Zone Classification
.5A me 8v A1zs SINOILE Farmu..y
4. ADDRESS ZIP Type Const.
Const. Occupancy Sprinklered
AMCWA) 2-3 Oyes ❑No 0 Req'd.
DESIGNER PHONE V. 'ation Building Area in Sq. Ft.
5. �' 1Z1GCna O
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
540 .—
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
TYPE ,�,/ ,.,�( No.Baths No. Stories No. Rooms No. of Dwellings
IJ NEW ❑ ALT. CJ AD'N. 0 RPL. 0 MVE. t I t i
7, OF ❑ OTHER
WORK BLD. CIPLMB. CIMECH. ❑ M.H. CIPOOL CERTIFICATE Req'd. Rec'd. Not q'd.
of EXEMPTION _ �/R�e
DESCRIBE WORK Enum. Dist. ILocation (Area) FEES COLLECTED
8. AOr~11-rr6 ) ` res Res iOE-r"G.. 1
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership / USE CODE
Public ❑Private YJ
''Z1�(a} UTILOITIFES CJ`'�1�Tt C Single $
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 Building *i8.00
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/,�® �, /, ,�/� Plumbing
DATE OF APPLICATION ` p� -(9,- 5'0 SIGNATURE OF APPLICANT.d'y�a(katJ-w%'• % /� - `�'�"lech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
iiiii0 / /.2/ SEPA >-
o_
Planning
i>
Mobile Home W
Fire Marshall
11
Co. Engineer AJ Other (Specify)
Utilities
TOTAL $ 18-00
Plans Examiner /
TQ5'iM Pc c).04-t-r )L/i1,70 WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician j� 'P . PERMIT IS NONTRANSFERABLE .1 Zj-1 5��'4'I 4� 8 `, a z 9 o°. r -
�7� ,e, t 9'- ' 1 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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10410 EAS1 JACKSON o SPOKANE, WASHINGTON 99206 • (509)924.2420 CLQ
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