1979, 11-06 Permit: 79-7384 Remodel Residence(PLAN NUMBER
l
APPLk ATION /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
Au<i UB IVI
LOT BLOCK SSION
LEGAL DESCRIPTION — SEE ATTACHED
2. 3 F H MAN 4-roN
OWNER
3 loo Vg1_-
ADDRESSS A , t'
tom, 57 5-7-49 AUVj
PARCEL NUMBER /S
ADP To 1-hATcHINSoN
PHONE
)5144 -a/or8
ZIP
CO NTRACSTOR
4. AA M cJo�1-rK4c-rot2.5 `Y2.6- 851415-
ADDRESS E % d I10 tit ISS/O'%J
DESIGNER
5' ADDRESS
PHONE
c12_44- -9864
Required Set Backs in Feet
North Ex [South )Q [East E)(' West 'f�C
ZIP
.__gam_ 9 5
PHONE
Size of Parcel
12.s ' o8' r
Type Const. Occupancy
ValItion
ZIP
/4/ Do --R?u
DWL Area I Basement Area
1D'o
Zone Classification
/4U12 AALM,'RAL SUES
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
/v6'o
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
2
No. Floors
CERTIFICATE
of EXEMPTION
No. Rooms
47 [
Rec. Room
NON,
Not Req'd.
Req'd.
Rec'd.
DESCRIBE WORK
8. K.EMO L or `' S' ,�. of 9E�Q g—rfN C: P-- _SipENCp
VALUATION Source GAS ELECTRIC WATER SEWER
of
000 Ay Utilities S`?N9
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. �--
DATE // ' lv ^ 7q' SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
RF.Mong` t5 ht..1_ )MSIpIE )rrN No
- Tp -rR3N of s /WIPE- 13aA PANEL.
WPtLLS
0 tG 014 Fly -K. /o . /5 �l 3o DAy
412Ac PE�RioD
2 Q- WHEN d°erMIT
IS l2-E J" /. �COjJT/�C`['01� --
DATE 1)-6-7Z OFFICIAL :.1
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /bT XX
DATE
PERMIT NUMBER
—71— 73 (5)�
02* *10400
* 10400
* 104006
B
*0,00
738,38
11 -06 -79
g 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
I. 1 -06 -79 738,4° *104002F1
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