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1980, 06-13 Permit 80-5750 Residence, Garage
(PLAN NUMBER -Z7 APPLICATION/ PEIKMI 1 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 ret OT BLOCK SUBDIVISION 2 �Cv I 1/ie4r r r r ksi9i9NI 4. OWNER 019 otOc-Lc ADDRESS CO":4V;6' 11 AD I;RESS� l 0 4- , 1(0 DESIGNER 5' ADDRESS ZIP Zp �v (PHONE672-;- ZIP °6 PHONE ZIP LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S 0544—I I /_ I' Actual Set Backs in Feet North (South Size of Parcel Type Const. Occupancy Valuation 76 (vlain Flgor Upper Floors East 'West Zone Classification Sprinklered ❑Yes ❑No ❑ Req'd. Building Area in Sq Ft. 2—i©� Garage Area Storage CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Iro.NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL El OTHER Area of Decks No. Baths Finished Basement No. Stories No. Rooms Unfin. Basemen No. of Dwellings DESCRI E WORK $ �It�01 L/6 -<ikM I [,-t' L I o �1.G, too, ( VALUATION SOURCE GAS CT,RIC WATER SEWERO F 1" Nil 9. UTILITIES CERTIFICATE of EXEMPTION Enum. Dist. I Location (Area) Ownership Public ❑ Private ❑ 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 REVERSE SIDE FOR REQUIRED INSPECTION DATE OF APPLICATION �� SIGNATURE OF APPLICANT Req'd. Rec'd. Not Req'd. SPECIAL APPROALS NAME DATE Env. H Ith Planni`' 6 /O Fire Marshall Co. Engi 1)/S Utilities Plans Examiner j� M fe 5TL. -W»-r G// SEPA Checklist SPECIAL CONDITIONS: 01 HAI I, -° cv•! -w- 0 PA-t2• 4/ FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL 1 c) 57sv l 02* *325.00 *325.00 1, 7-) E *0.00 54572 06-05-80 2 6.479. • WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. ing echnician PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE 06-1Y-80 DATE ISSUED 575,O2 *325,00°� PERMIT NO. TOTAL