1980, 09-17 Permit: 80B-0344 RemodelPLAN NUMBER
2.
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
LOT BLOCK /0,94),s- SUBDIVISION v.?
rii
OWNER
3. 2.'4Z/L /744e /9K
LEGAL DESCRIPTION - SEE ATTACHED
/97.veo", r,�rrr
4.
5.
6.
ADDRESS
PARCEL NUMBEF /S O� 'a— /So
PHONE
9z9 -
CONTRACTOR
ZIP
b
�:W. -c /Vu -ss
ADDRESS
PHONE
92e-/-8/65
Actual Set Backs in Feet
North 'South East (West
Size of Parcel Zone Classification
/.50 ..e a
/Q6 -e
DESIGNER
ADDRESS
4/7 rPr
ZIP
Type Const.
Occupancy
PHONE
Valuation
CHANGE OF USE FROM
ZIP
Main Floor
Upper Floors
Jim C' Fy..--/-rsc
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
9cxJ
Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
er/NEW 111 ALT. ❑ AD'N. ❑ RPL. 0 MVE.
0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
DESCRIBE WORK
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8. ��'« �Jc. ✓T
VALUATIONliSOURCE GAS ELECTRIC
%
9. 1 b IS UTI LOITIES
Enum. Dist. l Location (Area)
WATER
SEWER
Ownership USE CODE
Public ❑ Private IV
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 INSPEC I
DATE OF APPLICATION f
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
Building,jechnician
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
f[JR6 [ Jr--6rv(L kivir % > h 1i�X
14-r: VI iK6iAl
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
iv
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
75-0344
02* *68.00
*6800 tJ7
*68.006
A *0.00
34,32
09-17-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 9
DATE ISSUED
54.4°z
PERMIT NO.
*68,00
TOTAL