1980, 12-23 Permit: M80B-5190 StoveLAN NUMBER APPLICATION/ PERMIT
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 I BLOCK IbUBDIVISION I PARCEL NUMBER/S
OWNER
ADDRESS
PHONE
r�- t
ZIP Actual Set Backs in Feet
-Z—� I North South
CONTRACTOR PHONE
Size of Parcel
Zone Classification
'bA MCL
4.
ADDRESS ZIP
Type Const.
Occupancy
Sprinklered
AMCIs
I
❑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.
Baths
No. Stories
No. Rooms
Nq. of Dwellings
TYPENo.
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OFD OTHER
ElBLD. ❑ PLMB. Le MECH. ❑ M.H. ElPOOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DESCRIBE WORK
Enum. Dist. Location (Area)
8• �,pp ,4C
FEES COLLECTED
VALUATION1
SOURCE
GAS
ELECTRIC
WATER
SEWERUSE
Ownership
CODE
9.
OF
UTILITIES
I
I
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
Building
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 INSPECTIO S
Plumbing
DATE OF APPLICATION SIGNATURE OF APPLICAN
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Plans Examiner
Building
JTe hniciaan PERMIT IS NONTRANSFERABLE
��/1. `._-74--, PERMIT EXPIRES f1NF VFAR 9=111(1M InATF ('IF: ICCIIANCF
TOTAL $ °c=am
PERMIT NUMBER
IBJ 0 o36 S tq 0
04* *7,00
*7.00
*700
A *0,00
c 1 O 9 c
712-23-80
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
12�='il'-.'8 5 19. 0 z
nATC ISCI1rn DCOnAIT hill
*Z00COL �j
T'lT n.