HomeMy WebLinkAbout1980, 10-01 Permit: 80B-1234 InsertNUMBER APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
�j NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS r LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK ISUBDIVISION'PARCEL NUMBER/S
2.
O ER J
PHONE
A DRESS1"
ZIP
Actual Set Backs in Feet
?
' / ✓ _ vtrC!
/
ZO
North South East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
4' RESS
AD
ZIP
Type Const.
Occupancy
Sprinklered
44,f -LL
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
I Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
I
Baths
No.
Stories
No. Rooms
No. of Dwellings
TYPENo.
❑ NEW ❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
❑ BLD. ❑ PLMB. ;I MECH. ❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
1 7
Enum. Dist. Location (Area)
FEES COLLECTED
1"w Lad -
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
UTILITIES
Public ❑Private ❑
Single $
1 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 construc ion or.the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
Plumbing
G ��'`�'' `�
"Z
SIGNATURE OF APPLICANT`�
DATE OF APPLICATION �4 "—,V4)S
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
iv. Hea
anning
re Mar
Co. Engineer
aminer
nicia/1 PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
Al
04* *7,00
X7.00
1 23.3r'
10-01-80
6479.
j,
TOTAL $ /
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
123,4°
DATE ISSUED PERMIT NO.
*7.00-
a
T TAL