1979, 08-29 Permit: M79-3032PLAN 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.S.
LOT BLOCK
2
OWNER �}
3. 1VPci �C QinSar1
ADDRESS ,EiLs .404141626.4,3r_
N.9isPn
CONTRACTOR
4 AVVI Qac t44+tri Lie
ADDRESS
SUBDIVISION
P ONE
a�-�
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
ZI P
PHONE
Required Set Backs in Feet
North (South
East 'Wes
"isz 10a
DESIGNER
rJ. ADDRESS
CHANGE OF USE FROM
6.
TO
ZIP
99a/
PHONE
ZIP
Size of Parcel
Type Const.
Zone Classification
Occupancy
Valuation
DWL Area
Split Entry
Basement Area
Sprinklered
Oyes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Split Level
Storage
Rancher
TYPE ,r NEW
7. OF
WORK ❑ BLD.
❑ ALT.���--❑yyyAD'N. ❑ RPL. ❑ MVE.
❑ PLMB. ya MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
ESCRIBE WORK _/�
wQrk E/mac_ .
VALUATION
9.
Source
of
Utilities
/'c-vrr
GAS ELECTRIC r7 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 co struction or the
performance of construction.
DATE 0-c2-7 -7? SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D_ REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE 8/L.77 OFFICI
APPR
SUE, IR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
1" 3
od
Me h.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ l3. 00
PERMIT NUMBER
-79 -- 30 3..2_
DATE Q " 07-7-- 7
04* *1300
* 13.00 N
* 13008
A *Q00 8
30318
08-29-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-29-79
303.25 *13.002 _