1980, 09-15 Permit: 80B-0242 Residence PLAN NUMBER �� ., 1 y' APPLICATION/PERMIT ,PERMIT NUMBERa. /� ��
1C l �� '��O SPOKANE COUNTY BUILDING CODES DEPARTMENT CV
d
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675
•z 0.2
_, APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS 0 2 .„ * L Cl 1'(' C,
LEGAL DESCRIPTION — SEE ATTACHED
1. C 1463 f —0-1AV , ;. 201: 00
LOT BLOCK SUBDIVISION PARCEL NUMBER/Szc054Z- /OS3
2. 1-t+1= W, 9(.6'oF- -rtitE £ . Zgj,6 'OF-c'►iE NE v- * 2 0 1.0 0
OWNER PHONE OF tHi✓ NEAi- 0E---11-10 NLi)k. OF- Sc 2Q,— n * 0.C•,0
3. 4OM*..LANO -130/41DF S IJJc. `Z26- 2-14.171G 25- 44., EXc THE N. ('70' 11-1g0-13f
ADDRESS 1 ZIP Actual Set Backs in Feet 2(� 1
.Z
N 12. . /e4ytt4r)No R.nA.19 (P.O . 1349-3 192-i6, North 8 .- 8 l/i 'South 3East 3 .5" WestCONTRACTOR / PHONE Size of Parcel ' Zone Classification I I 0 9- 1 5-'` 0
��-��f6 Cf1.(oi X /SOS Aai2tcitu tliZAL 6479,
4' ADDRESSrZIP Type Const. Occupancy Sprinklered
l/.-r4 12,-3 Oyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation OnBuilding Area in Sq. Ft.
5. I 31/OO 8 k ?/6
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
21 .__--
CHANGE OF USE FROM TO 4F -eeaa EY o6ti cks Finished Basement Unfin./Basement
6. /64F/(d
No. Baths No. Stories No. Rooms No. of Dwellings
TYPE
NEW ❑ ALT. ❑ AD'N. 0 RPL. 0 MVE. r l 171. 1!
7. OF ❑ OTHER
WORK I�BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK Enum. Dist. I Location (Area)
8. R�Sj poicgi Derck-s A-r-rAc HE-P -No QP.../4 Ci F- l FEES COLLECTED
,VALUATION SOURCE GAS ELECTRIC )WATER SEWER Ownership USE CODE
00 OF
9. 70 *UTILITIES .1313Vf f.- 1, Sei1%.11c Public 0 Private H' Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included oo _
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing thisBuilding 201 x�
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 r the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIO S i ' Plumbing
41.1'
DATE OF APPLICATION p c SIGNATURE OF APPLICANT E_.. _ Mech.
SPECIAL APPROVALS / SPECIAL CONDITIONS:
NAME DATE 011 O FILE $'-9_4 -" Plan Check
Pt4-r of l MA►' w1•f-r /0; SS 1 S MSlgts E4 SEPA
E-7 -1, 16.4.i• Oe
Plann rg U
Mobile Home "'
Fire Marshall _
Li:
Co. Engineer Other(Specify)
Utilities TOTAL
$ 01- 7S�
Plans Examiner
'UM pos.-ruttier' f/J% WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
Building Technician PERMIT IS NONTRANSFERABLE .r 9''.•;1.51'.. 9',,a 4.2•z 1,2 0 1 0 0 a
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
PERMIT NO. -
�I N
••r . Spokane County
I I. Planning Department
1: NA "'- Short Plat •
,�s; !'.. .AIV• e� ;,AilY,: 'Ii
':Y:' ':."1' ) 'I�. :....V • • Exemption Certificate
1 . WAS THIS PARCEL SEGREGATED BEFORE MARCH 13, 1978, OR WAS APPLICATION
TO SEGREGATE MADE BEFORE MARCH 13, 1978 ? 0 4
(exempt under section 3.3B5 of Short Plat Ordinance)
2. IS THIS PARCEL 10 ACRES IN SIZE OR LARGER ? YES l:1
(exempt under section 3.3E of Short Plat Ordinance)
•
3. WILL THIS PARCEL BE USED FOR A PUBLIC UTILITY FACILITY ? YES
052
(exempt under section 3. 3B4 of Short Plat Ordinance)
4. IS THIS SEGREGATION BEING ACCOMPLISHED TO EFFECT A MINOR BOUNDARY
OR PROPERTY LINE ADJUSTMENT, BUT NOT CREATING ANY NEW LOTS OR
CAUSING OTHER LOTS TO FALL BELOW MINIMUM ZONING STANDARDS FOR SIZE
SHAPE OR FRONTAGE, OR AFFECTING ROAD ACCESS TO ANY OTHER LOTS ? YES
Ci0
(exempt under section 3.3H of Short Plat Ordinance)
5. IS THIS PARCEL ZONED RESIDENTIAL OFFICE, LOCAL BUSINESS, COMMERCIAL,
FREEWAY COMMERCIAL, INDUSTRIAL OR MANUFACTURING ? YES el;;)
(exempt under section 3. 3B4 of Short Plat Ordinance)
' DATE: 7 /8 /.�'o
IAPPROVED BY: �� i- .44;� Opp'
I hereby certify the answers I have offered in connection with obtaining
this exemption are true , A/', at-
,'
APPLICANT'S SIGNATURE: 5c: 4o t---- :-..- DATE: 7 / g3/ /1D
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