1979, 10-12 Permit: 79-5865 Residence Renewal of N-0829•
PLAN 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. /
2. _:1 `ZJ.a.4U . 1/2-u. adet
OVQN R
3. .P�e LI Q� ��/.��yLQ +2� •-(124-,•
x ESS
4.
5.
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
o9D
PARCEL NUM BER/S �J`j� _/gv/
�.D T /57.-/K._
✓/{ N /-/,E,e--s f't pi,
1y 44-44/
CO TRACTOR 77
�. f L•yvl' Q
ADDRESS
LLQ'
DESIGNER
ZIP
99 21q
Required Set Backs In Feet
North !South
East
(West
PHONE
ZIP
Size of Parcel
Type Const.
Occupancy
Zone Classification
4.4
' prinklered
' s ❑No ❑ Req'd.
PHONE
ADDRESS
ZIP
Valuation
Building Area in Sq. Ft.
X
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
•
-7
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
CI ALT.
El PLMB.
❑ AD'N.
O MECH:
O RPL.
O M.H.
❑ MVE.
— THER
❑ POOL((�,�����/Y,,��,�ff��((
A.di��.v"�`
No. Baths
N
Split Level
r�- 4f:
No. Floors No. Rooms
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DESC IBE WOR
VA UATION
c. _, l.,2,- l_e4,LJI2I
/.%
Source
of
Utilities
GAS
ELECTRIC
f
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 L'.—/ / / SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE/0-1-2-7 OFFICIAI £44J ��
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building ,,;29
Plumbing
Mech,
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
79
DATE /C)--
02*
D-
02* *29.00
*29.00 N
*29,006
B *Q00 8
58648
10-12-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10 -12 '- 7 9
5'86.55 *29.0.021
RECORD OF INSPECTIONS
4
Final Inspection
DAL REMARKS INSPECTED BY
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10 -1S -.d
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