1979, 11-19 Permit: 79-8061 DamperPLAN 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
ci
(..;1
LOT
BLOCK
SUBDIVISION
OWNER ff
3 Dig (7.e.k I 'c' G-'
PHONE
gayV 12a
ADDRESS yy//
/474 j7 C 1 C.
r/LCRAc !/Q'
CONTRACTORO�/ ,C C
4. 41! 1
,V Ct..A1 ! y H�'�" / .� rL /%4G
v -4
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
ZIP / Required Set Backs in Feet
7 �['� North 'South East IWest
ADDRESS p
g %v? 9/6; /4//4/2.-�u',z. tc , j�e /� 4C
DESIGNER
5. ADDRESS
PHONE
C/_t8 —A/0v
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
ZIP
Cico
/
PHONE
ZIP
TO
❑ NEW 0 ALT. 0 AD N. 0 RPL. ❑ MVE.
❑ BLD. ❑ PLMB. 0 MECH: ❑ M.H. 0 POOL
❑ OTHER
DESCRIBECcWORK
$• /SYS'/c/ .&li_..+�r �I
VALUATION /
9.
Source
of
Utilities
Size of Parcel
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation
DWL Area
Basement Area
Split Entry
No. Baths
Building Area in Sq. Ft.
Garage Area
Split Level
No. Floors
CERTIFICATE
of EXEMPTION
ve. 7- Mit 414-e Wealex
GAS
X4?(
ELECTRIC
WATER
SEWER
Storage
Rancher
No. Rooms
Req'd.
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. AM 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 »-i y 77 SIGNATURE '2271,e-'2:- "7I L7'c�� 'ate
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS: - n e
//-/9- -76? Q
DATE OFFICIAI ^ "%_L 4Ca/LI/w"--
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
t.-.4,0rrs y vv
Plan Check
SEPA
Mobile Home
Other (Specify)
3.oc
TOTAL $ 2• F 6�
PERMIT NUMBER
7q-rO6(
DATE / /9 -79
04* *7.00
*7.00 C
*7008
E *000 0
80602
11-19-79
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES.A PERMIT. d
.1 -19 -?9 806,1z
#/.
w
cn