1980, 08-15 Permit 80-8633 Residence!PLAN NUMBER ' l
I - er/ 1 8 /s-ao
APPLICATION/PERMIT
SPOKANE COUNTY — BUiLDIN'G CODES DEPARTMENT
PERMIT NUMBER
80'e 33
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. AtiaiigEzr .SPC/ticE,e ' A t.'C ei824.
LOT BLOCK SUBDIVISION
OWNER
3. 7/7J Z Yee-'
4.
5' ADDRESS
ADDRESS
h04)7 FeAbRt T Zw.
CONTRACTOR
Bea- : 30/C,Ct"oeS , //VC
ADDRESS
R7' S A4v. -4/66
DESIGNER
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
Liz NEW ❑ ALT.
MIBLD. ❑ PLMB.
TO
❑ AD'N.
❑ MECH.
O RPL.
O M.H.
PHONE
9ZZ'08C/g-
ZIP
ZOC
PHONE
ZIP
99406.
PHONE
ZIP
❑ MVE.
O POOL
0 OTHER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S •74,,,ter SP 79-/44/ r PT'V
at ►}/ 6R coy Belev4 * ITN or CjriV7 c S 1
Cvc/T L E3 d Y4 iVC y aF ,r''m1 ltiV !Z ra
CIS-44y2- 9/30
Actual Set Backs In Feet
North.S‘r 'South ebZ East 4/5 t (West $S /
Size of Parcel
Type Const. I Occupancy
Zone Classification
/902/G.U.Tu/2/4L
Sprinklered
Oyes ❑No ❑ Req'd.
Val9hlon Building Area in Sq. Ft.
aq 74i 06 zZ2z.
Area of Decks
Finished Basement
No. Baths I No. Stories
Unfin. Basement
No. Rooms No. ofDwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
DESCRIBE WORK
8. S/
VAL ATION
7�Ca
i
41/
SOURCE
OF
UTILITIES
GAS ELECTRIC
WATER
SEWER
Sri
Enum. Dist.
Ownership
Public ❑ Private le
Location (Area)
USE CODE
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 INSPECTIO
DATE OF APPLICATION g- 6 SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env/Health ,
PlaTrfir g �
Fire Marshall
In. Xechnicl _ 4j
SPECIAL CONDITIONS:
L►e Se• cm: 9z":?
C4C4 Co tJ7fe cre) 2 83 -2_0c/
8 r r. tJo i3
(Jc IKA9Koail
G//v r'-r zzsl
wri4 6000 . O 1 11b
�>�►J�s 110p 65 . Kam) k2. p�� •-ry
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
of F3eq'd.
FEES COLLECTED
Single $
Building 'r ��:X7° 00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 3Sg4 dQ
02* *358.00
*35800 17)
*35800.�
E *0.00
863.22
08= 1 5;-80
6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0, 8 1'5'2 WO' 8 6 3. 3 z .*3.5.8, 0 0 a [2. -
DATE ISSUED PERMIT NO. TOTAL
/J'