1980, 07-15 Permit: 80-7102 Residence•"‘
PLAN NUMBER
CJ
APPLICATbN/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1.
2.
L�T
114f).
Sl7B IVISION�
LEGAL DESCRIPTION — SEE ATTACHED
ILGti-LYvs�.A,
PARCEL NUMBER/S
OWNER
3. « 2;:k/(, 1► -►C.
4.
DRESS
t' i 7Q>c -2367
K ('.
CONTRACTOR
PHONE
ZIP
a"(11—a70
Required Set Backs In Feet
North 0 (South 'West ( 0
PHONE
East
I I si
Zone
Size of Parcel fication
4f,,,I) 3l 06 A PAa3o. i V, •
ADDRESS
ZIP
Type Const.
Fret �.
Occupancy
5FR
Sprinklered
❑Yes gNo ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valua ion
53L 75
ZIP
Building Area in Sq. Ft.
ISM 3b`by
DWL Area Basement Area 1 Storage
Split Entry
CHANGE OF USE FROM
6.
TO
Garage Area
IKAF
TY
Split Level I
Rancher
TYPE
7. OF
WORK
NEW
BLD.'
❑ ALT. El
❑ PLMB. ❑
DESCRIBE WOAK
8.5;:,,, le. fa. m ; 1 y
VAL TION Sour
of
9. Utillt
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performan a of construction.
DATE //4/10
SPECIAL APPROVALS
DEPT. REQ'D.
AD'N. 0 RPL. 0 MVE.
MECH: 0 M.H. 0 POOL
de
GAS rrt
ce
les
0 OTHER
No. Baths
No. Floors
CERTIFICATE
of EXEMPTION
No. Rooms
7
Req'd.
Rec. Room
Rec'd.
Not Req'd.
IC WATER SEWER
LECT R
Ve rte.
V e r�
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or local law regulating construction or the
SIGNATURE
REC'D.
En�ylHealtpip J f
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
P19/0 . rI 1r1151° 6Z -6'3)
talc, 02.3 ., o f �j3 - 1311- t 243 3
4/x3/81
Myk k_ 1° aCr01,1111
NO Go mOr S
DATE /L-/`JOFFICIAL
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
DATE --1, 5—X- r.'i
2* *29500
*29500
*295.00
E *0.00 8
69672
07-1.1`=80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COM A PERMIT.
01-1 `-80 7'0,125 *295002
iticPGrTfl