1980, 08-13 Permit: 80-8534 Residence PL NUMBER,- 1 // APPLICATIOI�I , ERMIT PERMITNUMBER
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SPOKANE COUNTY BUIL Nt1 CODES DEPARTMENT 5
VNORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
02 * * 1F1.00
JOB ADDRESS9)11 i -ri-4 LEGAL DESCRIPTION - SEE ATTACHED * i F 1.0 0
17,
LOT BLOCK I SUBDIY SION PARCEL NUMBER/S � 14 3,0
— /'
,ONE
2. 1 ,�u1.1-h/t•I kJf c i' A +0v r c * 1 E 1.o 0
6.11E1,1 cokid
3
ADDRESS ZI Actual Set Backs in Feet 8 5 J 3
14 09-1 6- i��f�1Jice^✓ North ISouth37 East 7-49
(West 07
CONTAA,w,C,,TgqR PHONE Size of Parcel Zone assificatior 0 8— 1 3—8 0
In 8Y7 )< I2- 1Lq1A- - 6,4 7 9,
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building rea in
Sq. Ft.
5' ADDRESS ZIP i aaiiinoFIor Uppe Floors Garage rea Storage _
—
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. 39& 6i-2—
TYPE "..3---No.B the No. Stories No. Wooms No. of Dwellings
N W 0 ALT. 0 AD'N. 0 RPL. 0 MVE. 4
], OF 0 OTHER CERTIFICATE Req'd. Rec'd. Nottq'd.
WORK ���LLL BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL
of EXEMPTION
DESCRIBE WORK Enum. Dist. ILocation (Area)
8. ` ' vJ * f + .I/ 1/41474\- irJ
FEES COLLECTED
VALUATION SOURCE GAS V`' ELECTRIC yWATER SEWER Ownership Ownership �,.i_/ USE CODE
OF
9. UTILITIES Y t �(� TIC Public 0 Private UG Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included f' _
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building p25✓
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
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION r f ! SIGNATURE OF APPLICANT 0l -Al Mech.
SPECIAL APPROVAL ,SPECIAL CONDITIONS: /
NA7ME DATE Gy rr yn,. A i� (�/M &is3 �{ 721—) Plan Check
Env. He t / ,/q((11 ,-IIf, I✓�� NI '-1 (/ ( ', J
g CD
�'L / �/"I 'tl7 OW IV f/� SEPA 0
_ c.)
Mobile Home W
Fire Marshall --i
L
Co. Engineer Other(Specify) 74--
G‘ rr
Utilities Q�
TOTAL $ I+V1
Plans Examiner n fia �'• " t ° '
�a ��f� �tl PETIT � �ta�xe.`..
Engineer's5 � WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist Contact � THIS BECOMES A PERMIT.
olid' echnician Ivo, PERMIT IS NONTRANSFERABLE i 8 -1,1 .3<—j8 0 8 5 4 c
IIst.1 8 1.0 0 a l�-
/ 7/5VI PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
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