1980, 10-24 Permit 80B-2601 GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
r
)I� ra(G\
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3676
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
LOT
2. /,j
OWNER
3. kir4/1) A. CliG6a1?-r
ADDRESS
. //6o C llG/ C-e
BLOCK
I
U DIVISION
F/4)/Z/l Aee5 Mosicc 443A?,
CONTRACTOR
• ADDRESS
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
qe..g� & Z7y
ZIP
PHONE
ZIP
PHONE
ZIP
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S 0957/_ �o fsr
Actual Set Backs in Feet
North 57 / !South
Size of Parcel
7t
Type Const.
Occupancy
Valuation
fj3S/el o
Main Floor
TYPE
7. OF
WORK
EITNEW ❑ ALT.
117 BLD. ❑ PLMB.
DESCRIBE WORK
8. ,D Ti4e1Q
❑ AD'N.
O MECH.
jz VALUATION
9 3g4.oc
SOURCE
OF
UTILITIES
GAS
❑ RPL.
❑ M.H.
ELECTRIC
D MVE.
❑ POOL
WATER
❑ OTHER
SEWER
5e7PPC
Upper Floors
Area of Decks
No. Baths
East IWest
Zone Classification
p /1-740/ //o
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
33 4
Garage Area
Storage
Finished Basement Unfin. Basement
•
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist. Location (Area)
No. Rooms INo. of Dwellings
Req'd. Rec'd. Not,q'd.
Ownership
Public D 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 INSPECTIONS
SIGNATURE OF APPLICANT VVgnA
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
FEES COLLECTED
Single
$
Building 4 2.3. oo
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
02* *23.00
* 23.00
* 23.008
A *000
2.57.32
10:-23`-80
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Buil ing Technician
1o/z3/Eo
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
DATE ISSUED
2'60;1 z *,2 3:0 O.a 1-2
PERMIT NO. TOTAL
(f-A- eJJ-:E