1979, 10-12 Permit: 79-5869 Residence Reneweal of N-0812rPLAN NUMBER
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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
1.
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LEGAL DESCRIPTION - SEE ATTACHED
CONTRACTOR
4. j2l,Jj./a� ,LQ_
A RESS
AZ/144,1---
PHONE
PARCEL NUMBER/S
h...07--/ '3 J /
V •-1 A/ : f,E,E.S / CP
ZIP
Required Set Backs In Feet
North 'South East (West
PHONE
Size of Parcel
ZIP
Type Const.
Occupancy
Zo Classific�tion -
prinklered
❑Yes Ohio 0 Req'd.
DESIGNER
5' ADDRESS
PHONE
Valuation (Building Area in Sq. Ft.
/Z 34
ZIP
OWL Area
Basement Area ( Garage Area I Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
O ALT.
O PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
O M.H.
DESfiRIBE WORK
8.. /( p,ru . ,,LIc- C J4 4 -c) -mak"
VAL ATION Source G
of
9. Utilities
❑ MVE.
"OTHER
❑ POOL .�
A -O �
No. Baths
No. Floors
/
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
X
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 / ��, —/ `�' - 7 /_ SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DAT61D-1.- 7%FFICIAL)ea..-ga G�GI/f
APPROVED FOR ISSUANCE _
FEES COLLECTED
Single $
l‘)Building :3/
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
Du
TOTAL $ 3�
PERMIT NUMBER
DATE /O —/c2- --79
02* *31.00
* 31,00
* 31.006
B *Q00 8
5868
10-12-79
A 6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COMES A PERMIT.
10-,12-7.9 5'86.95 *31.0,0a�
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1_
RECORD OF INSPECTIONS
T !•
Final Inspection
REMARKS INSPECTED BY
10-1S—A6
b
;0'00
a21'OUR
*21UU
CS« ►21'00