1980, 01-08 Permit 80A-9911 Wtr HtrPLAN 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 4 COPIES
AA-G
, DATE
JOB ADDRESS
1 LOT
LEGAL DESCRIPTION - SEE ATTACHED
2.
OWNER
3
4.
BLOCK
ADORES'?
CONTRACCCT
ADDRE S
DESIGNER
5' ADDRESS
SUBDIVISION
rev WEi-haxel('4/
7 0 6
.41,-1,1_40.414
e 3 7 c' 7
P ONE
PHONE
:— 70
PHONE
PARCEL NUMBER/S
Required Set Backs in Feet
North (South East 'West
Size of Parcel i Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes DNo ❑ Req'd.
Valuation (Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
TO
❑ NEW ❑ ALT. 0
9D'N. ❑ RPL. 0 MVE.
❑ BLD. ❑ PLMB. MECH: ❑ M.H. 0 POOL
❑ OTHER
Split Entry
No. Baths
Split Level
No. Floors
No. Rooms
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
So
u6 ELECTRIC
ce
Utilities
WATER
SEWER
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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE I —C3 COs-OFFICIAL q'k. 1 'ta/vovv.OI'0
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
�dG
Other (Specify)
TOTAL $ Qv
PERMIT NUMBER
W-(\— ` \\\
04* *9..00
* 9,00
*9.006
E *Q00
991,02
01-08-80
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
" 9. Q ,1J l a E-'
GAS
991,1Z