1979, 12-03 Permit: 79-8639 Remodel Residence,'PLAN NUMBER
i
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
2. 3
BLOCK
•�
5UBD V ION
OWNER,
PHONE
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S 0 2S41-1..2 -376 3
tvTa .5.LK=L
Ro.c?ERT L6015
SUL3.
AODRESS
7/0vNC OR rixtz •
4. . Kl./),vhC
ADDRESS
join/14i --
DESIGNER
6' ADDRESS
ZIP
Required Set Backs in Feet
North 'South
East (West
PHONE
Size of Parcel
i/oxo -r
Zone Classification
ZIP
Type Const.
Occupancy
Sprinklered
Dyes ❑No 0 Req'd.
PHONE
VaWation AP
ZIP
.Sacro
DWLArea Basement Area
'k�/ I S$�'
Building Area in Sq. Ft.
72 4
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
ElALT.
❑ PLMB.
O AD N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
IDPOOL
t.q OTH Red
Split Entry Split L vel . Rancher
d •CI1N1-rf, , .044,
No. Floors) •No. Rooms Rec. Room
No. Baths
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK n .t
ALUATION0
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 correc . 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 5:16•• — 7 J SIGNATURE.
1PaQ.C.efe,cc —
Sourc9f
of
Utilities
GAS
ELECTRIC
•
WATER
SEWER
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
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(2.a a-tv ,Piusdi
.2-.3-79 y�
DATE OFFICIAIt�r
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ sO
PERMIT NUMBER
79- 8/
DATE
02* *5Q00
*5000
*50.0.06
B *Q00
86382
12-03'-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
:121-.05?;709' 8'6192 .*.5a0:02. -
uAi REMARKS
r -
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
1S Cs -9Z
3P38�
t"�
4`2000;-..;
42(;0