1979, 09-07 Permit: 79-3565 Residence(PLAN NUMBER
9 -
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
E. %i 77 A!/<; Ave.
LOT BLOCK SUB gi�VISION
e A d tl a,U
1 E
3. o NJS tru
P071 /V02/7 Spy /(4w,
CONTRACTOR
e
4. ADDRESS
PHONE
q) 7 3, /o
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER /S —V 75-7
&oT -/ g// - yI D :r(e Add, t,0,0
ZIP
Required Set Backs in Feet 7 .,�
/ / I /-� % 30
North �(f7 'South �(/ East �/• West
Size of Parcel Z e Classification
9 1(/)-3 3,,u. F� t- fi, s
Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
ADDRESS
ZIP
CHANGE OF USE FROM
6.
TO
DWL Area
Split Ent
y
Basement Area
TYPE
7. OF
WORK
NEW ❑ ALT.
BLD. ❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
Split Level
Y- �PLJe/
No. Floors No./Rooms
Building Area in Sq. Ft.
/ i' �
1 Garage Area
7
D'
g
Storage
Rancher
Rec. Room
Not Req'd.
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
9.
DESCRIBE )./, ORK
N 'z Si A)
VALUATI N
4->M
Source
of
Utilities
GAS
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 permit does not presume
to give authority to violate or cancel the provisions of any other state or local law relating construction or the
performance of construction.
DATE
SIGNATUR
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Uti'Iities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
PLANK. okpp r
DATE -I -S -7_1 OFFICIAL .,l dtr} firLiktuir
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
DATE "' — 7' 7q
02* *82.00
*8200
*82006
E *Q00 8
35642
09 -07 -79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-07-79 556.55 *82002E-2.
DATE REMARKS
RECORD OF INSPECTIONS
*9
Final Inspection
INSPECTED BY
06-0A-A6
22(iitt%
• 0,
1#8SOOR
*CISOG
!9500
/2,4 -, r/7 / i< /</s'4/4 - 075 7
F'
R & R CONSTRUCTION CO.
P.O. BOX 14217
SPOKANE, WA 99214
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