1980, 09-03 Permit: 80-9527 Shop �w16ER APPLICATION/PERMIT PERMIT , R
I OA°' - - t SPOKANE COUNTY - BUILDING CODES DEPARTMENT I ,,. '?
(/ NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
K7 111 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
C! * * 2 0 U
JOB ADDRESS 114 LEGAL DESCRIPTION - SEE ATTACHED
LOT I _BLOCK SUBDIVISION PARCEL NUMBERS
3 1-3 *2. i `'173 ff, TA. ✓: , 1 - V
2
PHON * OU 8
3. joHdr.rM J •72 -250 i �.
-2..74
r 5 :, 1 p
� <..
P
acks in
ARES 172-4- 1_-TH ?!9903 7 Northal17 Set 2 'Sout Feet East (West 7 0 9- 0 2- 8 0
CTt 1l P/H_O/N`E Sizeio rc_el/ Zo a Classssifi�cation
COI!l�Fj14 Cb���s I I �4 � � M 9N4C—• - 6 4 7 9
4. ADD✓✓RE��SS ZIP TypellConst. Occupancy Sprinklered
Oyes ❑No 0 Req'd.
DESIGNER PHONE Valuation��� Bu'9-.0rg
5' ADDRESS ZIP MainGarage
Area g kAin Sq. Ft.
Floor Upper Floors GSore -
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6.
k( No. Baths No.Stories No. Rooms No. of Dwellings
TYPE
lid W 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER -
CERTIFICATE Req'd. Recd. Not 4'd.
WORK LLM BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL �/
of EXEMPTION
DESCRIBE W ' (.451a4)
12 Enum. Dist. i Location (Area)
,, Fic:,r C FEES COLLECTED
VALUATION! SO..T'CE GAS ELECTRIC WATER SEWER� 4 Ownership /USE CODE
9. IUTILOITIES .e:�y41•C-O Public ❑Private 9�
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
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type of work will be complied with whether specified herein or not. The granting of permit does not presume Building S
to give authority to violate or cancel the provisions of any other state or local law r ulating construction or the t
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing '`.`
uv
DATE OF APPLICATION 7./9/ SIGNATURE OF APPLICANT Mech.
SPECIAL APPROVALS SPECCIIALL CONDITIONS:
NAME
+ }�
NAME DATE 41-6`Y✓`r �bj �� t -'° I°
` Plan Check ,/'
Env. Health i
SEPA
Planning )
<,)
Mobile Home -
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Plans _
yr , 9/SWHEN MACHINE VALIDATED IN THIS SPACE,
SEP• Checklist THIS BECOMES A PERMIT.
c ,n• 31 ician PERMIT IS NONTRANSFERABLE 0:9 -Q3: 3i'lj 9 S 2, %- • * 3 8. 0 0 a•°'• -
' + �/� PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
C ?.I - 4
p�. = ydrs//
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