1980, 09-18 Permit: 80B-429 DamperMBER APPLICATION/PERMIT
P/ SPOKANE JEFFERSON COUNTY - BUILDING CODES DEPAR/ SPOKANE, WASHINGTON 99260 / (509) TMENT
NORTH 811
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
B ADDRESS A LEGAL DESCRIPTION — SEE ATTACHED
U NtK
3.
ADDRESS 1
PHONE
ZIP5T7-7-c?,j710— Actual Set Backs in Feet
North South
CONTRACTOR
ONE
Size of Parcel
Zone Classification
4' ,gepDR1ESS
Z' /v}/7��1 ✓ _
tZ�IP
! J �/ L
Type Const.
Occupancy
Sprinklered
[]Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5' ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
t Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished
Basement
I Unfin. Basement
6.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
❑BLD. PLMB. �MECH. ElM.H. El
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK //
of EXEMPTION
DES IBE WO�
Enum. Dist. I Location (Area)
FEES COLLECTED
8.
ALUATION
SOURCE
G S
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9,
UTILOITIES
Public ❑ Private ❑
Single $
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 Building
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
Plumbing
� � -"tf7
Mech.
DATE OF APPLICATION/ SIGNATURE OF APPLICAT**P
SPECIAL APPROVALS SPECIAL CONDITIONS:
Plan Check
NAME DATE
Env. Health
SEPA
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
PERMIT IS NONTRANSFERABLE
61'1; ted- PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Mobile Home
Other (Specify)
TOTA L $ _
PERMIT NUMBER
04* *7.00
*7,00
*7,00
A *0.00
42,8
09-18-80
;_9 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
o 0.x.:;.1,8 1 -1 81'0 4 2, 9 z
DATE ISSUED PERMIT NO.
*7.00COL
� -
TOTAL
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