1980, 02-28 Permit 80-1595 Shade CoverPI -AN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
.
LOTS BLOCK
SUBDIVISION
3. C
O/ NER
e�
AD• RESS (/
h' 7B.A4"k/Z1`3
CONTRACTOR
4. AD
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
D4 NEW
D BLD.
❑ ALT.
❑ PLMB.
PHONE
ZI P
PHONE
ZIP
PHONE
ZIP
TO
❑ AD N. 0 RPL. ❑ MVE.
❑ MECH: ❑ M.H. 0 POOL
❑ OTHER
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S ) .5 ///., ?I-0 ra,3
PDipT 1.34/( P Nye (IF x DFS� DF
�Xc!, $7: OPilo' /?7UN/7y-A/ eFS aF.c3/ (
OPPeR ruN/r5/
Required Set Backs in Feet
North /,.L/ / 'South %� / East / 70` (West /0 0
Size pf Parcel
.2-z
Type Const.
Valuation
Z-0 v C
Spli
No. Baths
Zone Classific.tion
S. I klered
❑Yes ylNo ❑ Req'd.
Building Area1Jn Sq. Ft.
Garage Area
Storage
ntry Split Level Rancher
e -- o
No. Rooms
No. Floors
CERTI FICATE
of EXEMPTION
Req'd.
Rec. Room
Rec'd.
Not
Req'd.
ESCRIBE WORK
GAS
VALUATION Source
9. 5U6 Utii ties
ELECTRIC
WATER
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 •ermit does not presume
to give authority to violate or cancel the provisions of any other st or local I r: •ulat ng construction or the
performance of construction.
DATE 84 SIGNATU
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
t)I.i,_ i%Vi`i•ir.;1i'S
SPECIAL CONDITIONS: Ut Lot'
DAT
OFFICIA'.y�.
APPROVED OR ISSUANCE
FEES COLLECTED
Single $
D
Building �v
Plumbing
Mech.
Plan Check
SEPA
Mobile Home -
Other (Specify)
TOTAL $ /D
PERMIT NUMBER,
DATE —-8�
0C)'.. is 1 0,00
* 10.00 N
* 1 0,006
E *0.00
159.42
02-28-80.
2 61479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 2)-12.8; = 18 0'
159,55' *10,00°i_
Cb4iu Litt
ND quc
condi
4°46