1980, 11-21 Permit: 80B-4048 ResidencePLAN NUMBER
g-
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APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
•
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
C.
/ 2/5- /77w
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2. /0
BLOCK
SUBDIVISION
--S'O "17? Ajp///ii 5 ''7,j
OWNER
3. AA' 7"/Stec'
ADDRESS
4.
PHONE
CviuSretic7icYr/
PARCEL NUMBER/S
5, 80z./cl�+i4
CONTRACTOR
ZIP
9`x037
Actual Set Backs in Feet
North /5e _South 3�
East —37 (West
PHONE
Size of Parcel
/0.5 X zZ9
Zone Classification
,Ci9rn/c y
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
5.
DESIGNEn
PHONE
Valuaji3n
Building Area in Sq. Ft.
ADDRESS
ZIP
Main Floor
/Z7c'
Upper Floors
Garage Area
72£'
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
.373i
Unfin. Basement
889
TYPE
7. OF
WORK
Id NEW
[Yf BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
2
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
,9•71 /-y
lt7E.5/h"irC./16
Enum. Dist.
Location (Area)
1
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Ownership .,/
Public ❑ Private c
USE CODE
9.5 5/ 3Cl0
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions include
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governin
type of work will be complied with whether specified herein or not. The granting of a per " it does nr
to give authority to violate or cancel the provisions of any other state or local law r.J At constru .r o
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS/�//,
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env alth
Planning
/1/47
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
Ton Pe5-rt.kwAir leo
SEPA Checklist
Buildinechnicia
/ 7— SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
4/651t'5c.' U/C 7.
J2 a/St 9g
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
/Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
$
*215. c9c)
TOTAL $ zrr S o0
▪ 1PErrnZ NUMBER
.?;nD - fe,45
02* *29500
*29500 N
*295.006
A *000
380.08
11-17-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED 80 N 48
PERMITO21 *2'95.904 -
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