1980, 03-19 Permit: 80-2403 Residence PLAN NUM ER APPLICATION/PERMIT
J` �.`� PERMIT NUMBER
'L7/�j/ SPOKANE COUNTY — BUILDING CODES DEPARTMENT R'D —,iL ''
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE �' /9-gQ
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS __ *• 1 0 0 0
LEGAL DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION N0. C NO. • PARCEL NUMBER/S ,4 33—ie.27 I I
2. w, 35'1.-Di .Exe: v'•-ALL Lary q * 510,00 ':-
ONVNER PHONE 7 11tea /-1 8L/(// :C3•ETrfr A)JS Ao.b
3. ii,/)."/"<1- /4 4J a -a l � * r, c
�A�DDRRESS [� ,y^/' �/q ZIP -Required Set Backs in Feet ' / '�l 3
// vi C_gh — Fe , �>„ 9 9-Z-a e North ,,3 9 I �- Q G
✓ South �� East / Ze) Mest 6
CONTRACTOR PHONE Size of Parcel / Zone Classifjca ion 0 3- 1 9-80
4. XZj&'-- - /..1J X. ''d A p P ,.6 e x i zt4,e,g,xftti, g, �°4/' nn
ADDRESS ZIP Type Const. Occupancy Sprinklered 7 7•
.l.I A/V�. v ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation DG Building Area in>Sq. Ft.
5. Storage ADDRESS ` c.3 7 � X14)4
ZIP /DWL Area/ rt a Garage Are,
/ s.1 c.7 IBasement A/s_"SG y,/c,
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE No.Baths No. Floors No. Rooms Rec. Room
y,NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF 0 OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION x
DE TRIBE WORK ^ i---
$, FEES COLLECTED
JESource
VALUATION I rr AS ELECTRIC WATER SEWER
of
9- 76 P d 0 Utilities
y Single $
I hereby certify that I have read and examined this application and have rept:ilie "NOTICE" •rovisfons included -
on reverse side, and know the same to be true and correct. All provisions of laws and ord ance$/governing this Building 'S 00—
type of work will be complied with whether specified herein or not. T1 e granting of a pe mit_'Oes not presume
to give authority to violate or cancel the provisions of any other st or local law,regul n.-6onstruction or the
performance of construction. s Plumbing
9' �
DATE /f-'-/q`-� / 7 SIGNATU' -a ... - �
Mech.
SPECIAL APPROVALS SPECIA C �
CONDITIO �
DEPT. REQ'D. RE
D. �/ Plan Check
Env.Health - ,CI^/� J�dG/�, ��
ry ,19/ �{ ./ko ///"`"'"
Plan in ���'t �./ - SEPA cx
- -� j/�' '. • / '"_ U
lel.e
/ ‘411:1 X )1 19/ (I 0_
r Marsha II I ArrIzov, PLUS 16-1-1J lam/W HMobile Home
Co. Engineerf/ I I L/ Other (Specify)
Utilities
00
TOTAL $ ,.:310--
Zone Clearance
SEPA Checklist PIANS OK WHEN MACHINE VALIDATED IN THIS SPACE,
L� riff �//� THIS BECOMES A PERMIT. 'I
DATE 1Z."��//i OFFICIA / Vit, -.i =J �I L4 L) z *2 1 Un., a it
APPROVED FOR ISSUANCE
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(1/11-3 0 -5 I CI7 41. • / $ .906
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