1979, 08-10 Permit: 79-1954 Residence'PLAN NUMBER
ee
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
t7
LOT BLOCK SUBDIVISION
0at6 A -
LEGAL DESCRIPTION - SEE ATTACHED
2. f 1 1t J 3o IVO ^ b 41( N
3. OWNER � 4 1
ADDR
1 1 76) 90 ;vri-1-1204
CONTRA OR
6 CM-1W
ADDRESS
4.
ZIP
° ?; 3
I
E? _2)323
ZIP
PARCEL NUMBER /S ION
°7r 4'- It9wI 1661 662
Required Set�BJ6 b7Feet
No th 17-77 7
2 ( ISouth3r)
Size of arcel
East 4 IWest
Zone Classification
ype Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
6.
CHANGE OF USE FROM
TO
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF
WORK 45/BLD. E3 PLMB. El MECH: ❑ M.H. ❑ POOL
DES �R I B WORK k 11\1
VALUATION
9. &C.), L2 OP
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 lo al law regulating construction or the
perform -ice of construction.
Iii' Area I Bpsemnt re Garaga
Split Entry
I Level
Storage
Rancher
❑ OTHER
No. Baths
No. Floors
oms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
Source
of
Utilities
V''
GAS
ELEC7IC
WATER
a WI..
SEWER
DATE
SIGNATURE
DEPT.
Env. Health
Planning
Fire Marsha;!
Co. Engineer
Utilities
SPECIAL APPROVALS
REQ'D. REC'D.
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
Pkiim Kim �e
X a
DATE /v Z
OFFICIAL'
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
00
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
PERMIT NUMBER
7 9- 061
02* *8200
*8200
*82006
A *0.00
132.22
07 -31 -79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-1 -79
19 5, 4 Z *32.O[ a F
•
DATE REMARKS
•
t
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
JM551
4 p
=95002
*9500
S/7
/4/7 d
4
•
\ •
•
r
I»/
agar