1980, 03-07 Permit 80-1922 Demo ResidenceIBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
PERMIT NUMBER
2.
3.
5. ADDRESS
LOT
OWNER
BLOCK
ADDRESS
CONTRACTOR
SUt3UI V ISION
ADQ4E/—I �� I n C+1
DESIGNER
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑/NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
L7 BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
ORK
8. DESCRIBE 1400
VALUATION Sourceof G S ELECTRIC
9. 5061 Utilities
OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North South
Size of Parcel
Type Const.
Valuation
DWL Area
Split Entry
No. Baths
WATER
Occupancy
Basement Area
Zo e Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Split Level Rancher
No. Floors
CERTIFICATE
of EXEMPTION
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
l'of construction.
J
DATE " 1- 6 O SIGNATURE -W
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
(iv.,, Lil'J WARRANTY
NO Li
SPECIAL CONDITIONS:
DATE
OF
No. Rooms
Rec. Room
Req'd. Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building IC)
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
0 2
E
19212
03-07-80
2 6479.
* 10.00
* 10.00
* 1Q006
'*0.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS RgC10r41c$.A{�EIIRMIT. 1 92„2 z *'1 0,0 '13''li 1
APPROVED FOR ISSUANCE
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