1980, 10-24 Permit: 80B-2661 Residence'PLAN NUMBER
1 i7 /031
lv/
APPLICATION/PERMIT
to 17y igb SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKC E. WA!'4INGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
3.
JOB ADDRESS
C•/9Bo7 i7rnV
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK SUBDIVISION
/
-6..>E4 ref iilorirr,s
OWNER
13 €' corv57-le rcrlon,
ADDRESS
f!O.0ox /X3Z'3
PHONE
92<-.J89
PARCEL NUMBER/S
2�0�E11c 6c?
ZIP
cit? 3
Actual Set Backs in Feet
North /.5 'South 3v' 1East 7'West 7'
4.
5.
CONTRACTOR
IQ/%s6.
ADDRESS
DESIGNER
PHONE
Size of Parcel
90}f 2i 3
Zone Classification
Si�v4t E
r/9/#9,6i1
ZIP
Type Const.
V_N
Occupancy
)Z -._S'
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE tion
V
se rp /6,
Building Areain Sq. Ft.
+ a 8
ADDRESS
ZIP
Main Floor
Upper Floors Garage Area
74,
Storage
CHANGE OF USE FROM
6.
TO
Area gal Decks
1514
Finished Basement
Unfin. Basement
/moo
TYPE
7. OF
WORK
,L, I( NEW
IJ BLD.
O ALT.
❑ PLMB.
❑ AD N.
O MECH.
❑ RPL.
❑ M.H.
O MVE.
O POOL
0 OTHER
No. Baths
3
No. Stories
No. Rooms
51
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not;Req'd.
DESCRIBE WORK
8--✓w6Gc' ##1/L47
411 VALUATION
Enum. Dist.
ILocation (Area)
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
�'PTlG
Ownership USE CODE
Public ❑ Private
nu
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
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 INSP TIONS
DATE OF APPLICATION /0-11'80
SPECIAL APPROVALS
NAME DATE
EnVHealth
Planning
/172-6)
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
TDM Pa -r u)ArT'%3ho
SEPA Checklist
$'uilding Technician
SIGNATURE OF APPLI
SPECIAL CONDITIONS:
.Cza:;)+,
4/cfrA.,
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building #3i7' 8
Plumbing -
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
02* *313.00
* 313.00 N
* 313.00
A *0,0,0
2660-2
10-24-8,0
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
8- 0.0
DATE ISSUED
2 6 6.1 5
PERMIT NO.
*313,002
TOTAL
Fii F rnav