1979, 10-12 Permit: 79-5867 Residence, Renewal of N0824PLAN 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 ADDRESS
1. S•(J21� SE ST kpAP
I
2.
LOT BLOCK
2 I
SUBDIVISION
LEGAL DESCRIPTION — SEE ATTACHED
VAN fiSE.S ApvrrioN
OWNER
3. Lttgley fEPt..INSK 1
ADDRESS
P o» o)( I4-L.1Q
CONTRACTOR
4. ADDRESS
PHONE
9.7.1— 6Qga
ZI P
2/41'
PHONE
PARCEL NUMBER/5 e-rN of 2-3543- 'Sol
Required Set Backs in Feet
North FL -X.,. 'South [East (West
Size of Parcel
ZIP
)474
Zone Classification
Type Const. Occupancy
5.yisi _LE PAM 1 L f RES
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
rJ. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
1145
ZIP
DWL Area I Basement Area Garage Area
CHANGE OF USE FROM
6.
TO
Ile if 1V/
Split Entry Split Level
Storage
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
O M.H.
❑ MVE.
O POOL
L�lOTHER
No. Baths
No. Floors
Z
CERTIFICATE
of EXEMPTION
No. Rooms
-5-
Rancher
Rec. Room
Req'd.
Rec'd.
Not Req'd.
L/
DESCRIBE WORK
8• Rgav EWA) O F KE IDFN
Source
Utilities
VALUATION
9 4,) oflities
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 regulating construction or the
performance of construction.
DATE
•
iZ
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
SIGNATURE Le..1.:4-(../N
SPECIAL CONDITIONS:
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
` .�Clrl�ilflr�l J
/ZENEWAL OF t P Mi -r NO,
N o ?z4F-
2 KENE1UkL *2./
DATE/61_/-79OFFICIA
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
79 -.586-7
DATE
02* *29.00
* 29.00 lz
* 29.00
8 *G00 0
58662
10-12-79
2 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
101-12-79 58'6.7'= *29,0,0°�
RECORD OF INSPECTIONS
,oar; *5)'
Final Inspection
REMARKS INSPECTED BY
vt
JU—Js—Ad
26Ygoi
LC 0 0 2
*56-00R
#saac N
cs• •S600