1979, 10-12 Permit: 79-5861 Residence, Renewal of N0805PLAN 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 AD RESS
1. •4 42&4.4
LOT BLOCK SUBDIVISION
2.
LEGAL DESCRIPTION - SEE ATTACHED
O NER
3 ,1LtL-1--.
/11D R S
PHONE
PARCEL NUMBER/S c2 ) .,y 3_`ko f
L. T ,t; L3
1 /A Al
A QLD
(S: /441/0 i -t/
CO
4.
5.
h.ITRACT R
Azkiid
De," ESS
DESIGNER
./
ZIP
�f 9 i'
Required Set Backs In Feet
North 'South
East 'West
PHONE
Size of Parcel
ZIP
Type Const.
Occupancy
Zorr Classitl tion
�l �c ..f,L
prinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
//$-4,
ADDRESS
ZIP
DWL Area !Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
7.
TYPE
OF
WORK
❑ NEW
❑ BLD.
O ALT.
O PLMB.
❑ AD N.
❑ MECH;
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
NVOeT���HEERpp
SplitEntry
No. Baths
Split Level
Rancher
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
X
DESCRIBE WORK
8. VALUATION
L'� /CL Z- L4 «, �a. I l�.Iq.QiLLP,GC,iitl ei
9.
Sou ce
of
Utilities
`
GAS
EL CTRIC
DDS
ATER
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 regulating construction or the
performance of construction. L�
DATE �U /"� — 79 SIGNATURE �
c.c <1411—.LL
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. HeaIth
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATEAa /-'-79OFFICIAL,Ed/oez
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
4V,572
..e
TOTAL
PERMIT NUMBER
7y
DATE /D-/<2.
02* *29.00
*29.00
*29006
8 *000 0
5860f
10-12-79
B 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
UP -1
5+86,12 *2 9.0,0
--DATE
t•
.REMARKS.
gC0
0q1,1 4,-SHOEt,
RU .11 1OP CTO[ R .
•
r.
•
•
Final Inspection
INSPECTED BY
• aO-J5�.1a
g *0.00 8
*S6002
*S600 -
Os* *S600