1980, 03-26 Permit: 80-2695 AC ,PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
4 N\--v-) - -;),('"l�
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
o NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 * * 100
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 7,0 0'E'-
2. Oft. E r
2e
P ONE_
n, l ',
3. D" '/ ��c'-t- �e 2694z-
•DP'ES / ZIP,„.,�, Required Set Backs in Feet
/v / 5-e4 6/>) Z(3 North 'South East (West 0 3—2 6-80
CONTRAC OR l' PHONE Size of Parcel Zone Classification
z -e _ ' f=//76 - c_
6.479
�sc�t a �-,
4. Ait E p Type Const. Occupancy Sprinklered
37C7 142- - Eyes ❑No ❑ Req'd.
DESIGNER 8 PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE KNEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE.
7. OF 0 OTHER -
CERTIFICATE Req'd. Recd. Not Req'd.
WORK 0 BLD. ❑ PLMB. ,MECH: 0 M.H. 0 POOL
of EXEMPTION
DESCRIBE WORK �� •41/C.1_,8 iLa7r�p de'i7-%L-tt el •41/C.1_, FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities 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 or the
Plumbing
performance of construction.
06
DATE SIGNATURE_ Mech. 7
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health 6—+/7)
„rn 8 rte. tr
SEPA o
1—
Planning U
W
0-
Mobile
Mobile Home cn
Fire Marshall z—
Co. Engineer Other (Specify)
Utilities g 6e)
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /) l\ THIS BECOMES A PERMIT.
S -V
DATEUvOFFICIAL L<it."/ti7171i / L 6 r 2 L U /.
APPROVED FOR ISSUANCE —