1979, 10-12 Permit: 79-5859 Residence, Renewal of N-0828PLAN 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
JO,Et ADDRESS'
1 - LOT LOCK
2. / 1 2
s Islo /'
ALL•F.L�-;C .
LEGAL DESCRIPTION — SEE ATTACHED
oktplER
3. iG�
J)A DRE
.
eCONTRACT R
ADDRESS
DESIGNER
4.
5.
')'l%L l_/ %-01if,?.• •
PHONE
PARCEL NUMBER/S =)5� t —�857v/
OT/ eLf
vA A/ N,EF,S .d 1)0
)
ZIP
PHONE
Required Set Backs In Feet
North 'South
Size of Parcel
ZIP
Type Const.
East (West
Zone Classlfiicatlon.
Occupancy Sprinklered
Oyes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq./Ft.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Spilt Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
O MVE.
O POOL
Q OTHER
No. Baths
l
No. Floors No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
9gSCRIB WORK
8. � K •>�v�.Gei f -f C ..i'tit n1
VALUATION Source GAS ELECTRIC WA £R SEWER
of
9. Utilities
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 /Z.) `J 71 SIGNATURE ISI
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
•
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATI?� /2-7' oFFICIAI AI/G{.G
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building l e,‘.1
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
7q--
DATE
qi—
DATE /U -1-2--7y
02* *31.00
* 31.00 6
* 31,006
B *000
58588
10-12-79
4479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-12-79
585.92 *3LO,Oa1-2
DATE REMARKS
RECORD
OF
INSPECTIONS
Final Inspection
INSPECTED BY
JO -15—;6
.000 2
*2i'00
0s.
+2100