1980, 07-09 Permit: 80-6872 ResidencePLAN NUMBER APPLrY'+`...-ik J ION/PERMIT PERMIT NUM;., -r<
SPOKANE COUNTY - BUILDING CODES DEPARTMENT C) - 7�
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
�. e, /vx, -5/ 57
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
2. /z
OWNER PHONE
3. 56" f GldrlfiML9sv7 E7CrN55
-3�/S
/v nF 285 y� '-53//
A7DDRESS
ZIP
Actual Set Backs in Feet
7��
I"-0, &�e
9r71'Z//
North 501 South &vq r East West 1.31
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
5-b X /,�
'4 v a e
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
SAMC�
I
[]Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valu ion
Building Area in Sq. Ft.
33.x'
9y
s.
ADDRESS
l P
Main Floor
Upper Floors
Garage Area
Storage
shy
—
--
--
CHANGE OF USE FROM T
Area of Decks
Finished Basement
Unfin. Basement
6.
)
641
L l�
No. Baths
No. Stories
No. Rooms
No. of Dwelling
TYPE ,,..,/
L✓J NEW ElALT. EllA ElMVE.
SL
'Z
7, OF ❑ OTHER
BLD. ❑ PLMB. ❑ ME H. ❑ M. H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
✓
DESCRIBE WORK
Enum. Dist. Location (Area)
8
FEES COLLECTED
.�
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 of laws and ordinances this
provisions governing Z" -CO
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
ATF CIF APPI I('ATICIN /_/ 7 11" S1rNATI IRF n A P P I IC.ANT_
..FIA Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE '//9 r Plan Check
yNEA l�c:r4w�v..vy /4Pf9.21-1v.^o-c ory GoT Ar
�q7 SEPA
Co. 9 i r � / /�/L G` -7c. Z�•1r1.�' ��L/j�'L..0-/�
Utilities
Plans Examiner
6.
SEPA Checklist 10UIO )0:0-12 /^e/'0-1VCL7
Building j1echnician - - PERMIT -IS NONTRANSFERABLE
Mobile Home
Other (Specify)
02* *206.00
*20600 L
*206006
B *0,00 00
631.98
06-25-80
6479.
TOTAL $-zinG• C%
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
—6-R 7.2 0 * 2 n �.-o_iLP.