1980, 07-02 Permit: 80-6614 ResidenceAPPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / 1509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. e /�l� 2/ / 7 re' /7!/6
LOr
2. 7
B OCK
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
So4TH 42,4 01 /MD, nobs,
OWNER
3 M.ern wan Aber/As
ADDRESS
C. 75ro ,Seue.ccy
4.
5.
CONTRACTOR
ate
ADDRESS
Semis
DESIGNER
PHONE
get • 0975
PARCEL NUMBER/S
Z( S4/-2607
ZIP
y9zcC
PHONE
Actual Set Backs in Feet
North 77 r (South U3
Size o1 Parcel
/37X//Z
East 3/ (Wast .35
Zone Classification
Sny¢ce rAntn,y
ZIP
Type Const.
Occupancy
Sorinklered
❑Ves ❑No 0 Req'd.
PHONE
Val Ion
cp
Building Area in Sq. Ft.
/Jet/
ADDRESS
ZIP
Main Floor
/ago
Upper Floors
Garage Area
$89
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
/
Finishhed Basement
7co
tinfin. Basement
TYPE
7. OF
WORK
tv NEW 0 ALT.
M BLD. ❑ PLMB.
• AD'N.
❑ MECH.
o RPL.
❑ M.M.
• MVE.
❑ POOL
0 OTHER
No. Baths
Z
No. Stories
2Coe
No. Rooms
No. o1 Dwellings
./
CERTIFICATE
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
9 -
DESCRIBE WORK
8 SrkSGE 1C9» 4y'
ALUATION
9. SS,Soo
"arsiocr
SOURCE
UTILITIES
GAS E
GAS ELECTRIC
Enum. Dist.
Location (Area)
WATER
*CFI!
56P7i c
Ownership USE CODE
Public ❑Private
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 INSPECTIONS
DATE OF APPLICATION _ SIGNATURE OF APPCANT
SPECIAL APPROVALS
NAME DATE
f
//• e
Planning
Fire Marshal
Co. Engineer
Utilities
Plans Examiner
l•u f/
SEPA Check
in echnician
f, G 200
•
SPECIAL CONDITIONS:
g_. -151 /tpPIeovfn £ - 31- -i% AY TEW2y
/ 4/c 7 Oc, N62
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Sngle S
Building w0/r OGS
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specifyl
TOTAL
PERMIT NUMBER
80^ G6/9
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
66142 *301000.1 -
PERMIT NO. TOTAL
0