1980, 07-25 Permit 80-7660 Residence, Garage%/ Z5-/& C�
APPLIrs1.ATION/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
E. /0 3; 7
LOT BLOCK SUBDIVISION
2. /7
/ erez r "9442 Tic'N
OWNER
3. G/51Z / i- 07''f
4.
ADDRESS
0/Za "�.eRc7 ale
CONT RACTOR
SA
ADDRESS
SAjne
PHONE
Sze -eggs
ZIP
r
176i!y
PHONE
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
054s//-/6/ 7
Actual Set Backs in Feet
North /8'' 'South 37
Size of Parcel
sXzGT.
Type Const.
Occupancy
East Ski (West ..
Zone Classification
SiwCy4E.r4/4 y
Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER
5. ADDRSS
PHONE
ZIP
Valuation
yv6
Main Floor I Upper Floors
/27Z 960
Building Area in Sq. Ft.
Garage Area
�ZS
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Area of Decks
/Zo
Finished Basemen
Unfin. Basement
�80
U NEW ❑ ALT.
BLD. ❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
Z
No. Stories
No. Rooms
7
No. of Dwellings
/
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
V
DESCRIBE WORK
VAL" ATION SOURCEOF GAS ELECTRIC WATER
9. S�c!G UTILLITIE
8. S'A/i R'/9/1i •/ .�]e5: AE'�= li'NkA yE A7I.�F EIo
SEWER
S _sCte%/G
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private IYi
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 regulating construction or the
performance of construction SEE R VERSE SIDE FOR REQUIRED INSPECTIONS .. ..
DATE OF APPLICATION I I!."( 1 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
e
Planning
Fire Marshall
re)
Co. Engineer
Utilities
Plans Examiner
"TOM o'-,rg,r /z9J o
SEPACheckliSt
SPECIAL CONDITIONS:
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTA L
$313,c6
PERMIT. VUMBE
7.
02* *313.'00
*31 3.00 N
*31 3.006
E *000 8
765.9g
07-25,-80
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Buildi Technician
_i Odd
07 `2.50
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE HATE tCCI IFn
PERMIT IS NONTRANSFERABLE
76'605 *313.00
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