1980, 10-30 Permit: 80B-2988 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
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SPOKANE COUNTY - BUILDING CODES DEPARTMENT H - �`�08
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PP SS HARD TO MAKE 3 COPIES
�.r� LL * * 700
JOB ADDRESS ":. 0 U)
" LEGAL DESCRIPTION - SEE ATTACHED
is �;'
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2 `/ i 7
2.
OWNER ) PHONE 1 0-30- 30
ADDRESS ,may Actual Set Backs in Feet f' a 7 9
r ()• Rox 7G,3 `t�G/ North 'SouthEast 'West
CONTRACTORPHONE Size of Parcel Zone Classification
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
Oyes ❑No D Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage -
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
,// No.Baths No. Stories No. Rooms No. of Dwellings
TYPE
lJ NEW ❑ ALT. ❑ D'N. El RPL. 0 MVE.
7. OF 0 OTHER
WORK ❑ BLD. ❑ PLMB. MECH. 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK � Enum. Dist. I Location (Area)
8.
C . .� I r'IA �
®�+ 4Fw, FEES COLLECTED
I
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF
9. UTILITIES Public 0 Private 0
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
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 .r the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTION / Plumbing
c� j/ , ov
DATE OF APPLICATION An" 3e, J GNATURE OF APPLICANT _...-1:-.. / /�- -��.4- ech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning
U
Mobile Home —1
Fire Marshall t%
Co. Engineer Other(Specify)
Utilities
TOTAL $
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
i�a�.�jjn PERMIT IS NONTRANSFERABLE 1 Q & G.i', 8 D, 2 9 8,8 g i 7.0 0.2 H'
• r/�� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL