1979, 10-04 Permit: 79-5350 GaragePLAN 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. 92
LOT BLOCK SUB VISION
2. 27 / c e / J A-nfl TO 6iett_ry /4e.ee
3.
OVyNER
ADDRESS
C TRACTOR
u je 50/U /&L
4' ADDRESStzr c &
DESIGNER
5.
101- 711
agave
LEGAL DESC5IPTION - SEE ATTACHED
PARCEL NUMBER/S rAtil
/755 -'0/37 LLafLer a7
kty.:4127- 2,57, 016,ht_ee,„_„_e_4
Required Set Backs in Feet North 'South v 6 (East 10 (West
PHONE
Size of Parcel I Zone (ossification
•
/ /9.'7 x Z
�j[pe Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation Building Area in Sq. Ft.
39(r)cis"-
72c)
ADDRESS
ZIP
DWL Area I Basement Area f Garage ArArea
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
7.
TYPE
OF
WORK
,NEW
0• BLD.
O ALT.
O PLMB.
❑ AD N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
RIBE WORK
8.-7j()/ 7
VALUATION
Source
of
Utilities
GAS
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.sr
DATE /P- / ` / C7 SIGNATUR
DEPT. A
Env. Health
Planning
SPECIAL APPROVALS
REQ'D. REC'D.
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIO ' :
DATE OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
as
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
38 00
PERMIT NUMBER
79-5 35
DATE iv—1%" Ir
02* *3800
*38:00
*38006
E *000
534,98
10-04-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
555,0 *'38.00a1
THIS BECOMES A PERMIT.
10,-,04-7.9
IMoncnrno
Re
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