1980, 06-05 Permit: 80-5435 Patio CoverPLAN ;DUMBER
•
APPLICATION/PERMIT
SPOKANE COUNTY — RUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
JOB ADDRESS
i.e LOT if 4BLL/
OCK
2.�,�'• I � ?f
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
SU D71 ION L�
LEGAL DESCRIPTION — SEE ATTACHED
O NyER
ADDRESS
(C /"/'gid 9 - -'4 , rZ
iLe—
CONTRACTOR
5.
6.
ADDRESS
'�
DESIGNER
ADDRESS
PHONE
ZI P
PHONE
PARCEL NUMBER/S
4.Z.)7` L3s./: A S
,E ce,„I
Actual Set Backs in Feet
North p A (South
East q West .14‘,
Size of 9arcel
ZIP
Type Const.
Occupancy
PHONE
Valuation
CHANGE OF USE FROM
ZIP
Main Floor
•
Upper Floors
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
7d 1
Garage Area
Storage
TO
TYPE
7, OF
WORK
9.
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
pl AD'N.
0 MECH.
❑ RPL.
O M.H.
❑ MVE.
O POOL
DESCRIBE WORK
A"�`7 � (j
LU ON� � �.�" �j% �C�Gf��6�•'G�-'
SOURCE rGAS ELECTRI WATER
OF
UTILITIES
0 OTHER
Area of Decks Finished Basement Unfin. Basement
to - '112.41‘ -
No . Baths No. Stories No. Rooms No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd. I Rec'd. (Not Req'd.
11 `�
SEWER
Ownership I USE CODE
Public 0 Private J�1
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, 1
DATE OF APPLICATION
SPECIAL. APPROVALS
NAME DATE
SIGNATURE OF APPLICANT
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
/2"._ CA-
SEPA Checklist
B(((9i���Iding Technici r
JrAl..[i�'
SPECIAL CONDITIONS:
WA 1VrO t//, G )11:)-
iU,6C r'r / o
/-G404./C4 0.4-1 Z-XiSTG /'»,# frj
tv/71,4.,ar1Al e,42 , vCi' C... C,GCtrc �,jt c ifNtrj
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building '
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
(PERMIT NUMBER
coo'���cB
02* *2500
*2500
*25006
F *C00
5425E-
06 -054-80
425E06-054-80
0 6471
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
06,-0.5'-80
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
43,5 *25.00
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