1980, 11-14 Permit: 80B-3768 BasementPLAN NUMBER
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
J B ADDRESS
1. (4.:. / �r 1 / 7 z--4, t'1.iJ-L,
LOT
2. c5
BLOCK
l
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S ��d' �.,� 4/x'1 -7s% pier
ire <` f3xKl
TER
3. /)LSL?„
ADDRESS
e 7
CQN�jRACTOR
4. �rfoG. ei--� t-LyfC� yty � -'✓� .
ADDRESS f
DESIGNER
PHONE
,e ak99-4,37
ZIP
Actual Set Backs in Fpvt ••
North South'// llllEaS�
West
5' ADDRESS
PHONE
ZIP
C.f%,;/`f
Size of Parcel
Occupancy I �''Sprinklered
❑Yes No E Req'd.
Zone Classif'cation
r i?
Type Const.
PHONE
ZIP
luation
M1ain Floor I Upper Floors
Building/Area in Sq. Ft.
7 'i -' e/✓liDki
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
C N E W
�Q BLD.
Ntif ALT.
❑ PLMB.
TO
Area of Decks
Finished Basement
Unfin. Basement
❑ AD'N.
❑ MECH.
❑ RPL
❑ MVE.
❑ H. P9p L OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
D CRIBE WORK
F
VALUATIQN SOURCE
OF
944)4,14/ UTI LLITIES
/7o .,44-:
GAS
ELECTRIC
A7rER /
Enum. Dist. I Location (Area)
SEWER
Ownership
Public ❑ Private 1,4
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 constructiga'q or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION /if c -r/ SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning ,
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building
®Tec nicia
.f�(.azilV a/L
SPECIAL CONDITIONS:
x ../.q # L
AJC: k; NS& 'fr( 6 x
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL r 45-1-7
PERMIT NUMBER
02* *5600
* 5600
* 56.006
A *000
3767
11-14-80
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11ti4-80.
DATE ISSUED
57682 *56,00
PERMIT NO.
aaI-
TOTAL