1979, 07-16 Permit: 79-517 Residence1PLAN Nr ER
API-LICATION/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
1.
2.
3.
JOB ADDRESS
S, /91.Z. CON kL,1N RCAN
LOT
7
BLOCK
OWNER
RANSOM c:aNSTA. tic—noN
ADDRESS
N clic- PiNEs R D- . SF'oW 4r1F
7
SUBDIVISION
R1 D6 E M OI -r- Es-rirrE3 #2.
PHONE
/Nc. c124: -2.o.3
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
zss�l-
OL o7
CONTRACTOR
AAA
4. S
ADDRESS
DESIGNER
5. ADDRESS
ZIP
C/92-06)
PHONE
ZI P
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
CJ NNEW ❑ ALT.
n BLD. ❑ PLMB.
PHONE
ZIP
TO
❑ AD'N.
❑
MECH;
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
Required Set Backs in Feet
1 7 �
North /5 South%32
East 251 West 7'74'
Size of Parcel
illF X 167 i
Type Const. 1 Occupancy
1a-3
Vailation
oa
/2.01� Do0'Stx%
DWL Ar7a I Basement Area
2692 1 00
Split Entry
DESCRIBE WORK
8 �f�s11PENC — GNgAc A -Ni -DEck s D
VALUATION
9 /Z0 000-7(x
Source
of
Utilities
GAS
1 -Ti cHj
ELECTRIC
No. Baths
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
R39G,
Garage Area
Split Level
No. Floors
L.�
CERTIFICATE
of EXEMPTION
Storage
Rancher
2 S70R
No. Rooms
Rec. Robm
NONE
Req'd.
Rec'd.
Not Req'd.
1 -
WATER
UEFA
SEWER
5Eweg
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 •.verning this
type of work will be complied with whether specified herein or not. The granting of a permit •.e not presume
to give authority to violate or cancel the provisions of any other state or localw reg tiny co• truction or the
performance of construction. /
�i�.:
DATE SIGNATU
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
/0,et&, %/7y
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
oVMAfee
FPO 6a'
of O1 F1LE, /l-1-77
PLA -tis aK `7-16�iQ
DATE OFFICIAL- 'ry✓44-i
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
/2
Building 37U
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
71--.517
DATE JL(Ly iLji/71
02*
* 137.00
* 1 37.00
* 137.006
B *0.00
51.6
07-16-79
A 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-16-79
51.72 *157.0021-2
3 '0''
//8,//
e