1980, 12-09 Permit: 80B-4664 Residence PLAN NUMBER APPLICATION/PERMIT tMIT NUMBER
�� Z o 87 1 / /� ��. I �� �_ X66 �
SPOKANE COUNTY — BUILDING CODES DEPARTMENT I
4.' 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 ( U'
1. E .5¢\z i 4 Me ,
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. S '.. A4 S ACP i1 c _ r 00v
OWNER PHONE
3. AM�.be."�, T2 mrn.0. .5. 4-Cos—:--cf.‘ 235.34-030 .w r
ADDRESS ZIP Actual Set Backs in Feet
j. 133p t C ERR.r1Li_ gi2O-Z. North 31 (South East 2-0 (West '3
CONTRACTOR PHONE Size of Parcel Zone Classification r r, _ - r
X 1CX5 X i3Gs 5a NG.Ca Fr\ (<..y
4. ADDRESS ZIP Type Const. Occupancy Sprinklered r 0 J r
Swmc5 ❑Yes ❑No 0 Req'd.
DESIGNER PHONE Valuation BuildingAreain Sq. Ft.
_F '1+)346 1 { 30
5' ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
f 1430 --- 5-ZS . —
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. y ---- aC,2.-
,/ No. Baths No. Stories No. Rooms No. of Dwellings
TYPE
LI NEW 0 ALT. 0 AD'N. 0 RPL. ❑ MVE. -Z -Z__, 8 I
7, OF 0 OTHER
WORK g BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION V
DESCRIBE WORK Enum.Dist. I Location (Area)
EIS,
� c IL)/ e•D 6 GAR)4Z F Air 4C4-1 E p I FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
054,34 0 UTILITIES Sjeprtc Public 0 Private 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 *MS-co
type of work will be complied with whether specified herein or not. The granting of a permit does no g
resume
to give authority to violate or cancel the provisions of any other state or local law regulating construc ., or
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPE INS Plumbing
dr
DATE OF APPLICATION /r2 --5--•-41 SIGNATURE OF APPLICANTI� °FA:)
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env H Ith
/a/iSEPA ;L
PI nning (.J
Mobile Home r..!
Fire Marshall J
ti
Co. Engineer Other(Specify)
Utilities
TOTAL $ 298t,
Plans Examiner IZ"Zi
TbM. Por-rL wA)T `' vu WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
"'r
B ildi Technician �2 ,/�t x PERMIT IS NONTRANSFERABLE 121..8 i¢'!8 D. 4'6 6.4 Z *2 98.0 0 a ..
� � ?s PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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