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1980, 11-21 Permit: 80B-4048 ResidencePLAN NUMBER g- //,/,2///6-z, 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 - LI 0 c C LJ LJ