1980, 11-17 Permit: 80B-3812 ResidenceIPLtV NUMBER
�L-
2e37 I /1/n/gv
!O/
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE. WASHINGTON 99260 / (509) 6563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
t.
2.
3.
4.
JOB ADDRESS
e /$b'/5
LOOT
0
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
SUSO ISI ON
`wee.-ct liQee,e—rna.ydd.6 .
OWNER
UP6 64-:-r�LO�i902‘ al:tett
ngcrR ESS
/5;20 4e -it.
CONTRACTOR
PHONE (2775
ZIP
�y�d
PHONE
PARCEL NUMBERS ao J //_ &e. a '
Actual Set Batu In Feet I �1 �jv
North 90 ISouth .3P2 r `East m2.0r IWesl O j /
Size of Parcel
99x aio'
Zone la tion
ADDRESS
ZIP
Type Const.
Occupancy 1 Sprinkler
❑Vet IQN0 ❑ Req'd.
5.
DESIGNER
PHONE
Valuation Building Area in Sq. Ft.
529 ti" ono/a
ADDRESS
ZIP
Main Floor pper Fioors Garage Area Storage
/380 bile
CHANGE OF USE FROM
6.
TO
Area of Decks
catsC
Finished Basement
6/6
Unfln. Basement
TYPE
7. OF
WORK
la NEW
Yy BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Stories
laySej
CERTIFICATE
of EXEMPTION
No. Rooms
No. of Dwellings
• /
Req'd.
Recd.
Not Reg'd.
8.
9.
DESCRIB ORK ��
_ere, -7'W
VALVA ION
SOURCE
UTILITIES
OAA
S
or- 4t.A zf!(
Enum. Dist.
Location (Area)
ERCT RIC
WATER
SEWER
Ownership ��}}
Public D Pnvato gs
USE CODE
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 constru;.n or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION.
SPECIAL APPROVALS
NAME DAIS
Q 5 K5
Healtn
e
anning
Ire rshall
Co. Engineer
Utilities
-e
ans Examiner
r
LI
1 a'
SE PA
hecklist
Building
nnKla
1 SIGNATURE OF AP
SPECIAL CONDITIONS:
PERMIT 1S NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building )9?./N
Plumbing
Mech.
-Plan Check
SEPA
Mobile Home
Other ISpecifyl
TOTAL S
PERMIT NUMBER
grog
02* *29200
•29200
361.1 A
11 -17 -PO
t 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
111:171-'80
DATE ISSUED
38129 *29200niJ
PERMIT NO. TOTAL.