1979, 08-27 Permit: 79-2926 BarnPLAN 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
LEGAL DESCRIPTION - SEE ATTACHED
L BLOCK SUBDI ISION PARCEL NUMBER/S
,3_ -ib —
2. Al e,,j / S. _29d / &Ie
W, 2 ke, b
O NER -7� PHONE o 7-RAC 7-,/ 16-
3. dG S —:i V,E `I �U
ADDRESS ZIP Required Set Backs in Feet
f �
: North jrO South j6 W East West/��
T ACTOR PHONE Size of Parcel Zone Classification
4' AD49RESS ZIP Type Const. Occupancy Sprinklered
Dyes [—]No ❑ Req'd.
DESIGNER PHONE Valuation Building Area ip Sq. Ft.
5' ADDRESS Zip DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE � NEW, El ALT. �l AD'N. 1:1 RPL. ElMVE.
7, OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑PLM B. ❑ MECH: ❑ M.H. ❑POOL
of EXEMPTION
DESCRIBE WORK
8 r FEES COLLECTED
VALUATION Source GAS ELECTRICI WATER SEWER
of
9. Utilities
Single $
1 hereby certify that 1 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 Building l�
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
Plumbing
performance of construction.
DATE 71 SIGNATURE— � '���
--r— 'Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE ;P-Z'7--7�0FFICIAL $k1Cz1 % L
A nnnrrnrrn rnn 1001 1A ninc
SEPA
Mobile Home
Other (Specify)
CJ G
TOTAL $ 16
WHEN MACHINE VALIDAI
THIS BECOMES A PERMIT.
08-27-79
0 - -'C
PERMIT NUMBER
CI- zCr zC
DATE—Aid& 27.1479
02* *15.00
* 1 5, 0 0 v)
29252
08-27-79
R 6479,
2'92:65 *15.00aOP'
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