1980, 07-22 Permit: 80-6317 ResidencePLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
8� SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
SUBDIVISION
PARCEL NUMBER/S
2./l/
I 53
7o s
OWNER
PHONE
3. 116CiSCE Q,'— AUW,1614,1V3C5iS`
SYN Ot 2
ADDRESS
ZIP
Actual Set Backs in Feet
1 A
North (13' South ZS
East /O' West %O
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4'
/2� 9 k -6/
C7r?/.fii tfR.�3/919J
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
[--]yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valu tion
Building Area in Sq. Ft.
5.
3ei oo
�
ADDRESS
ZIP
Main FloorUpper
Floors
Garage Area
Storage
9(a -/ A
^
CHANGE OF USE FROM
TO
Area of ecks
Finished Basement
Unfin. Basement
6.
TYPE ,�{/
U NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Bat s
.Z
No. Stories
aZ
No. Rooms
�%
No. ofDwellings
7, OF �.,/ ❑ OTHER
WORK J BLD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
C RTIFICATE
Req'd.
Recd.
Not_'Ileq'd.
EXEMPTION
y
DESCRIBE WORK
8. 5/ii E �q/y1 `�/{ivC� L1/%L71E'C/�
En m. Dist. Location (Area)
FEES COLLECTED
VALUATION
SOURCE
1UTIL01TI
GAS
ELECTRIC
WATE%
SE ER
Ow ership USE CODE
Q. 3 OCS'U
ES
S �C
P lic 13 Private
Single $
1 hereby certify that I have read and examined this application an ave read the
' OTICE" provisions included
J
on reverse side, and know the same to be true and correct. All pro ons of law
and ordinances governing this
- Z10' OC)type
of work will be complied with whether specified herein or ot. The grantin
Of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other st a or local lov
regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQU INSPECTI NS
Plumbing
DATE OF APPLICATION SIGNAT TMech.
SPECIAL APPROVALS SPECIAL CONDITION. "I,
NAME DATE "FN`� �, �i3% f!p z,S BCS CJS Plan Check
Env. Health d!�T
Plan %'g U ;k4tJ/V"#V'q
YFi/ hal i(jQo✓ �P/�fd/?M//1,�/� 07Co. Engineer
Utilities
s Lxaminer
A Checklist
Jina_Technl
PERMIT IS NONTRANSFERABLE
n � Ly�
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
SEPA
Mobile Home
Other (Specify)
TOTAL $ Z%D' cyo
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
PERMIT NO. TOTAL