1979, 08-10 Permit: 79-1955 ResidencePLAN 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 ADDRES
I (6 61
LOT BLO
K
2.
Avo-
LEGAL DESCRIPTION - SEE ATTACHED
OWNE4R. �K
3.
ADDRESS
K T 1 E 0 Fill Nil
CONTR CTOR 6i-Nc,i
4. ADDRESS
UBDIVISION'
' M A120
PHONE
PARCEL NUMBER /S
[viztiot.4 of
0 75-F f- IG I (6,I f I &b2-1 1 6 9
Required Set Backs in Feet r1
North 6'(.J 'South' 0 [East 7-'2. (West
PHONE
(P)7- -O3�-3
ZI P
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
5.
DESIGNER
ADDRESS
PHONE
ZIP
Valuation
AV4rea
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
Split Entry
Building Area in Sq. Ft.
1 Garage Area
lit L evel
Storage
Rancher
III N W ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ OTHER
BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
Noths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
DES RIB WORK
VALUATION
9. &a t 00°
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 gr.' ping of a permit does not presume
to give . thority to violate or cancel the provisions of any other state o to law regulating constructio +r the
Source
of
Utilities
GAS_
ELECTRIC
WATER
«ri2O.'
SEWER
perfor r a ce f construction.
/ V
DATE
DE T.
SIGNATURE
SPECIAL APPROVALS
REQ'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
RECD.
tie. ›- z s
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
.P,Qo,I,0 e--10-7? 6
DATE 7";,f' OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
0'.00
DATE
PERMIT NUMBER
79- )95-5
02* *97.00
*97.00
to-
*
A *G00
13212
07 -31 -79
2 6479.
WHEN MACHINE VALIDAT IN THIS SPACE,
THIS BECOMES A PERMIT.
08 -10 -79 i95.5z *97,00 °�
DATE REMARKS
ti J
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
QRdd
Od-2J -.16
1251%
V
.000 g
4,6s00R
oS00
OS* .d. 0C