1980, 08-20 Permit App: 80-8826 17 FixturesPLAN 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
5.
ATRESS ,j0J
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FvLir
PHONE
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7
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PHONE
ZIP
CHANGE OF USE FROM
6.
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South East West
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
:Yes ❑No ❑ Req'd.
,9,72/1
Valuation
Main Floor
Upper Floors
Building Area in Sq. Ft.
Garage Area
Storage
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
fVEW �❑ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
y
❑ BLD. LMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
OF
UTILITIES
/7 i XTUI i�
GAS
ELECTRIC
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd
Not Req'd.
WATER
SEWER
Ownership
Public ❑ Private 0
USE CODE
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 , .ting construction or the
performance of construction. SEE REV RSE SIDE FOR REQUIRED INSPECTION
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing /7/5/1.5'D
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $16 + )0
PERMIO — 924.°
03* *4550
*4550
*45506
E *000
88252 q
08-20-80
z 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08i420.1:.TO 882,65 *45,502
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL