1979, 10-12 Permit: 79-5857 Residence Renewal of N0830PLAN 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 ADpRESSS
LOl' BLOCK
2`3
SU r r I'll SIN
LEGAL DESCRIPTION — SEE ATTACHED
2(a l( 1 AL (! d e.i(2 c ;r
4.
OWNER
Xi VG' Lit Asa X21'
AD RESS
• LL /141/'
CONTRACTOR"
• lit/
PHONE
J2(-'66' a
ZIP
PARCEL NUMBER/S
2 3.59:: -/a f:/
ccdd
Required Set Backs in Feet
North 'South
East
West
PHONE
Size of Parcel
Zon Classification
c/L 16 11)€:(/Sprinkl ed
ADD ESS
of 1U--
ZIP
Type Const.
Occupancy
Oyes ❑No D Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
9sv
ADDRESS
ZIP
DWL Area
'Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Ent
y
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
O ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
O MVE.
O POOL-
{
7 OTHER
No. faths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DE RIBE WORK
AL ATION
9.
r,., z'J ' 1 / 4(
Source GAS
of
Utilities
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
performanq of construction. /� L1
DATE ' -12 - /✓ SIGNATURE l `L[ (_RSA 1_,b41/12
/��
41/12 /)
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DAT/ _/�-� OFFICIAL
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ 2.T
PERMIT NUMBER
7 9--,5-g-5-7
DATE/2 — /�
7T
02* *2500
*2500
*25006
B *GOO 8
58568
10-12-79
2 6479,
APPROVED FOR ISSUANCE
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-x'12-79 5'85.7d *25.0,02
CD
Y --
U
C0`)
RECORD OF INSPECTIONS
Final Inspection
DATE REMARKS INSPECTED BY
5--16
*000 8
+52008
.5e0G
05. S200