1980, 07-09 Permit: 80-6888 ResidencePLAN NUMBER r'ERMIT NUMBER
�_ APPLICoAXION/PERMIT �
y SPOKANE COUNTY — BUILDING CODES DEPARTMENT
V NORTH 811 JEFFERSON / SPOKANE, 01ASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. E. RE ,p ,31ST U6" LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2. I 53 G v nv T cv vs e" 5
OWNER PHONE
3 usf O"" 4Lbt/I9i/fil4 n cSC.�ss
;,"- 3�,l5
frAl dF 28-:5q3-:5-30
ADDRESS
Actual Set Backs in Feet
v
0.,96,e 117
/ZIIP;
�/G�!
2
North 30 South l,/" East /✓ west 13- 5
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
5i9/n--
!.%a
ii14 2(. S 01341 ,14
4. ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
s4wGc
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
V�juation
Building Area in Sq. Ft.
�Il-3v no
8( _/
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage Area
Storage
CHA!' aE OF USE FROM
TO
Area of Decks
i Finished Basement
Unfin. Basement
6.
No. Baths
No. Stories
No. Rooms
No. ofI Dwelling<
TYPE
NEW ❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
Z
—7/
7, OF �/
L:7 BLD. ❑ PLMB. ❑ MECH. ❑ M. H.
❑OTHER
❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not RQq'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
C.
Enum. Dist. Location (Area)
FEES COLLECTED
8 ���G �N
ALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
u
9. 3�
OF
UTILITIES
jEPJ(G
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
Building -z(p.
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
Plumbing
IIATF (1F APPI If ATIOM \.+y / Z✓ / t QI(7NATI lQr r1C ADDI IrArLa�� �
Mech.
JYtUTAL AFPHUVALJ
NAME DATE
En Health
Ian
Fir M rshall
Co. ne
j
Utilities
Plans Examiner
,jm r s-r`nArr
SEPA Checklist
Bui^ldin echnician
02* *21000
*21000 'u-)
*210001
B *C00
631,62
06-25''-80
�? 6.479
SPECIAL CONDITIONS:
/} Plan Check
Xe, --o Y)t-ANAu, Alf APAROvAc CN LOT C)/-:' ZEG®rzo v
-7-0 �C� C'L��V�T.E'�II.TEp //1/ SEPA
6 eoft. IicE 60, 771Y Sirc= ID 176-0 _ c
8/Za Mobile Home
L
Other (Specify)
t,O Sfrcz ti ATTR C�
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
TOTAL $ S, od
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
u o z
DATE ISSUED7e _ l PERMIT U1 O�TA� �