1979, 07-11 Permit: 79-372 ACPLAN NUr.
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.
OWNER
ADDRESS
4 4/.'/ .�
SUBDIVISION
4.
CON RACTOR
PHONE
a-6- 5 -
ZIP
PHONE
L535 /7//
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North !South East 'West
Size of Parcel Zone Classification
ADDRESS
`-7? / c72 a-Q�a.
DESIGNER
5. ADDRESS
ZIP
77
Type Const.
Occupancy
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
PHONE
ZIP
TO
O ALT. 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. gMECH: ❑ M.H. 0 POOL
0 OTHER
Valuation
Sprinklered
❑Yes No ❑ Req'd.
DWL Area I Basement Area
Building Area in Sq. Ft.
Garage Area Storage
Split Entry
Split Level
Rancher
DESCRIBE WORK
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
No. Baths
No. Floors
CERTIFICATE
of EXEMPTION
WATER
No. Rooms
Rec. Room
Req'd. Rec'd.
Not Req'd.
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.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIAL"
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
�
7--
TOTAL $ / -�
PERMIT NUMBER
DATE/
04* *7.00
37.12
07-11-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-11-79
37.22 *7,0021