1979, 09-21 Permit: 79-4515 GaragePLAN NUMBER
fe 261
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
2.
JOB ADDRESS
Lij3 V 5/Vti2-�v
k7NER
LOT BLOC SU DI DIVISION
3.tpo r e
ADDRESS
CONTRACTOR
Slime
ADDRESS
4.
RA
LEGAL DESCRIPTION — SEE ATTACHED
PIJONE
PARCEL NUMBER/S /95i/
y) 62 J
6E-6, Q66, s5 �E• 7t �i2L, 5'N• or(5,to, core- jp ,
s w mases rir. w. i47' rib .W / 7.3' )7/4'4'. JS -o
-5, r0 Ave -
IP
(LL/)A t\
L
PHONE
Required Setacks in Feet
North 4/1/ISouth/05
East
Size of Parcel
Q ,
/3 'West
Z ne Classification
LIP
Type Cq n st.
Occupancy
J
S rinklered
Yes No ❑ Req'd.
DESIGNER
J. ADDRESS
PHONE
ZIP
Valuatjpn
DWL Area Basement Area
C,
BuildingAsea in Sq. Ft.
Gsage Area
340
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
LTJ -NEW ❑ ALT. ❑ AD N.
BLD. ❑ PLMB. 0 MECH:
❑ RPL.
O M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors Nolooms
Rec. Room
CERTIFICATE Req'd.
of EXEMPTION
Rec'd.
Not 'd.
IBE
8. re cTG r -t e KA C u r^ a -R
4VALUATIO
Sour
of
Utilities
(26' 3/
ELiECTRIC
WATER
SEWER
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? ^ /7 ` 7z1 SIGNATURE
DEPT.
Env. Health
Planning
SPECIAL APPROVALS
REQ'D. REC'D.
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
115 _A./Zia—a/1
o t12 D Fe
DATE 'r"--,' OFFICIA
FEES COLLECTED
Single $
ro
Building V o
Plumbing
Mech.
4
APPROVED FOR ISSUA CE
Plan Check
SEPA
Mobile Home
Oth+er(Speci
t `!
�o
TOTAL $
PERMIT NUMBER
DATE
02* *12400
* 124.00 v)
* 124006
E
*TOO
451.42
09-21-i9
B 61479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-21-7'9
451, 5z
7.4.00V'I-
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