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1980, 12-15 Permit App: 80B-4862 BarnPLAN NUMBER r+ - /a/, 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 1. LOT 2. OWNER 3. GA ADD ESS GlNM??o CONTRACTO BLOCK cli4MARotsi PR LEGAL DESCRIPTION - SEE ATTACHED SUBDI\ g'e'l• ISION 7114 /W PHON N'CC-)KE" PARCEL NUMBER/S 0101 4' ADDRESS 6 ZIP o6 Actual Set BackslIin Feet North ,W `South East 110 (West PHONE Size of Parcel IJx J3 Zone Classific ion M nk,U1 ZIP Type Const. Occupancy Mi S lered Oyes ❑No ❑ Req'd. DESIGNER 5' ADDRESS PHONE Valuation �ry '17-100 Building Area in Sq. Ft. 70C) ZIP Main Floor Upper Floors I Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Area of Decks Finished Basement Unfin. Basement IVJ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ OTHER IVBLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL No. Baths No. Stories No. Rooms No. of Dwellings CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Re d. DESCRIBE WORK 8. rOL' 7A VALUATION 9. C 1^1/ Enum. Dist. I Location (Area) SOURCE GAS OF UTILITIES ELECTRIC WATER SEWER Ownership Eti Public ❑ Private SE 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 regulating construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS DATE OF APPLICATION /2— / G SPECIAL APPROVALS NAME DATE ny2 ekIth Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist ing Tech clan SIGNATURE OF APPLICAN SPECIAL CONDITIONS: M sl 1, —rd vl� rJ PERMIT IS NONTRANSFERABLE FEES COLLECTED Single $ Building`_ Plumbing Mech. Plan Check SEPA Mobile Home Oth r (Specify) TOTAL $ P RMIT NUMBER 02* *'44,00 *'4400 t5 *'4x006 A *0,00 48582- 1.2-1`5-80 z 6479. 02* *'4400 *4400 *44006 - A *000 8 48592 12-15-80 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 12;115-18) 486,2' i88,002g PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL /73 / 'y 0 0 t P1 cI n 10 �- 3' n - p re. 5 •' .�n e_ . -1 t31.`44_ i Po id i♦.sct 7rs( Add• Sc.&ice. ,=..a 4 .5-,7`1 `/ ((1j0l�/� E- • 9,42. et rt 4404.