1979, 10-09 Permit: 79-5577 GarageFLAN 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
LOT BLOCK
3.
4.
,
b
SUBDIVISION
OWNER
ADDRESS
2--6716,
/r/716, 1.10 , 13Krt/_Or
CONTRACTOR
_ON SIS
PHO E19.
_�J
ZIP
PHONE
325.'1+6` --
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S � Q
acerb /6,,\I fFI7I2I1 IWT Sv
Imo•K1•-75 ,I60•
Required Set/��Backs in Feet
North 19 /,- !South East 'West 6,6
Size of Parcel
7x 1 1(c)
ADDRESS
KI -2-18 1,-/� '- --r
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7, OF
WORK
2.0g
PHONE
ZIP
TO
IILI NNEW ❑ ALT. ID N.
[ BLD. ❑ PLMB. 0 MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
8.
DESCRIBE WORK
CIA (O`/l
VAL(UUIIATIO '
9. COI 000
Source
of
Utilities
GAS
E(,.E, CTRIC
Type const.
Occupancy
171 -
Valuation
DWL Area 1
Basement Area
Split Entry
No. Baths
Zone Clsifica ion
•���Lll
❑ Yes
r klered
o ❑ Req'd.
Building Area in Sq. Ft.
56o
Ga56 0Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
WATER
amm
SEWER
No. Rpoms
Req'd.
Storage
Rancher
Rec. Room
Rec'd.
Not Req'd.
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 /O/7/ 7 7 SIGNATURE
DEPT.
Env. Health
Planning
SPECIAL APPROVALS
fYt 'D. REC'D.
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITI NS:
Go. -1 � A - 1,_1I -J2-23o- 4'
Irih "� 01\11O61-0
-FLAWS A-�" i A6I-1E4)
DATE
fr/P, OFFICIAL
2 i
APPROVED FOR IS DANCE
FEES COLLECTED
Single
Building 4
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $_5(CLIA.._
DATE
s..
PERMIT NUMBER
71-5S-77
lo —a-77
02* *5600
*5600 N
*5600
*Q00
E
5327f
10-04-79
B 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'1'0t0".71:9 5'57,7 z *56.V0 a r2
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