1979, 10-17 Permit: 79-6194 FixturesPLAN 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
LOT
BLOCK
SUB0iVI10N
LEGAL DESCRIPTION - SEE ATTACHED
3.
OWNER
PHONE
PARCEL NUMBER /S
ADDRESS
ZIP
Required Set Backs in Feet
North 'South East
'West
4.
6.
CONTRACTOR
ADDRESS
q5 c4fra
/1'66
DESIGNER ^
ADDRESS/
/4
CHANGE OF USE FROM
PHONE
ZIP
Size of Parcel
Zone Classification
Type Const.
Occupancy
Sprinklered
Oyes ❑No ❑ Req'd.
TO
PHO E
ZIP -ai
Valuation
Building Area in Sq. Ft.
DWL Area I Basement Area
Garage Area
Split Entry
Split Level
TYPE
7. OF
WORK
XNEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N. ❑ RPL. ❑ MVE.
❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Storage
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
VALUATION
9.
Source
of
Utilities
GAS ELECTRIC
WATER
SEWER
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance off onstr ction.
/
DATE 1tif 67
examined this application and have read
to be true and correct. All provisions of
whether specified herein or not. Th
the provisions of any other state
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
REC'D.
Zone Clearance
SEPA Checklist
the "NOTICE" provisions included
laws and ordinances governing this
ng of a permit does not presume
aw reg - g c.,�.truction or the
SPECI 'ji NDITIONS:
DATE/% % 7 7`oFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing ,c5.52
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
S
TOTAL
PERMIT NUMBER
DATE / /7 -7/ p
03* *2550
*2550
*25.506
E *0.00
619.32
10 -17 -79
g 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-1
619.42 *25.5,02
DATE REMARKS
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
CY-
E
.000 2
zesSe'r0
024, *5220