1980, 09-23 Permit 80B-688 Demo Prtn of DuplexPLAN NUMBER
9/43/ o
APPLICATION/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
• LOT7 BLOCK
/ 11/(:(4.1_-044-dit,/,
SUBDIVIS ON
3. owe, OJQ
4.
ADDRESS
CO TRACTOR
L
ADDRESS
2
DESIGNER
PHONE
ZIP
99.il�
PHONE
ZIP
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South East JWest
Size of Parcel
Type Const.
Occupancy
Valuation
/ 0 (1 "
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
ESCRIBE W
❑ ALT.
❑ PLMB.
VALUATION
9.
SOURCE
OF
UTILITIES
ZIP
TO
❑ AD'N.
O MECH.
❑ RPL. ❑ MVE.
A.1 OTHER
❑ M.H. p_zi P tr
�( AS ELECTRIC WATER'
Main Floor Upper Floors
Building Area in Sq. Ft.
Garage Area Storage
Area of Decks
Finished Basement
No. Baths
No. Stories
Unfin. Basement
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Req'd. Rec'd.
SEWER
Ownership
Public D Private 0
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 INSPECTIONS
DATE OF APPLICATION 9— 2� -�'o SIGNATURE OF APPLICANT
L.LtLs
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
Not Req'd.
FEES COLLECTED
Single $
Building .')a —�
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
go 0- 6,g.�
02* *20.00
* 20.0.0 3
* 20.00'6
A *0,00
6a7z
09-23-80
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
B ding Tec nicia
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
0 +9 160V.-.B11
DATE ISSUED
•
6 8.8
PERMIT NO.
*20.'0.0°r!
TOTAL