1980, 09-05 Permit: 80-9670 Residence PLAN NUMBERAPPLICATION/PERMIT PERMIT NUMBER
g_53 � �� � g��a
43` /4 SPOKANE COUNTY - BUILDING CODES DEPARTMENT
1-7� IA( NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
l% APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS a LEGAL DESCRIPTION - SEE ATTACHED
1. - / /O' : .: , ._ u,
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. /2. 3 i� ....SPAR, 5 O/7/00.1J -41 ,17"---
OWNER
-> `—' I ( �;
OWNER PHONE O I2 ir'( -.
3. /)/ SCO 0u/t.-tD e$ _ fig-q807 2Z/s.33.
ADDRESS ZIP Actual Set Backs in Feet r
11/, 30/O 6-bt
/VOv/ 0 '7 q Wel North 77' [South .z 5' East 7 d 'West'3cj' _, r,,,- L,. n
CONTRACTOR PHONE Size of Parcel Zone Classification
aAlaf E. `72 X /27 X46. $6/8 44/R0,9ev - 6 4 7 P
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
5AM6 Eyes ❑No ❑ Req'd.
DESIGNER PHONEuatbionon( O�/1� Building Area in Sq. Ft.
5. 495'3, S 78
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage —
e7P - /0
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. — e2..,--
.
No.
2._--
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE [ NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE. / ilk/ 5"
7. OF ,,_,/ ❑ OTHER Req'd. Recd. Not Req'd.
WORK LId BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CERTIFICATE
A of EXEMPTION V
DESCRIBE WORK Enum. Dist. I Location (Area)
8� „S/Akic.E /AM4!c v i76 - I FEES COLLECTED
/ VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
'. 3 0(.1C UTILITIES 5P7"i6 Public El Private [H'
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 0�i�.cC�
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___�'7/0(/_10 SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. e9I /PeAA/5 all ,/GC
Cp /1 SEPA
Planning
/�
a
C,J
Fire Marshall Mobile Home .�_a
I.L.
Co. Engineer Other(Specify)
Utilities
TOTAL $ 2/6- CC?
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Buildin Technician /� PERMIT IS NONTRANSFERABLE 0 9 L� 5j'_8 O 967. G '2 1 0.
�� f_ .�`3 elZ4�`-d PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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