1979, 10-05 Permit: 79-5403 Renewal Permit GaragePLAN NUMBER
JOB ADDRESS
1. N. S` "'
LOT
2B
OWNER
3, G 5
ADDRESS
M I S"o
CONTRAC
S&M
4. ADDRESS
DESIGNER
5. ADDRESS
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
LEGAL DESCRIPTION - SEE ATTACHED
UBDI ISION
PARCEL NUMBER/S 3++64q-0111 I -HF- AL 80, 0
-rhf- -S - 4.6 7.7 o f -r*F- E. 1'f7.1 o f
PHONE
MAS_ iOsi PLNT No, q/ wFsT F/4RMS
F -
92Z- 2zoo
19,9- -TAh,=Ts.
ZIP
Required Set Backs in Feet
Ci
North 1FE:— South East West
PHONE
Size of Parcel
Zone Classification
D'y '
ZIP
Type Const.
Occupancy
Sprinklered
I
❑Yes [-]No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
—0—
_0—ZIP
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM I
O Split Entry Split Level Rancher
6.
TYPE WOTHER
No. BathsNo. Floors No.Rooms Rec. Room
❑NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7, OF Req'd. Recd. Not Req'd.
WOR ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M. H. ❑ POOL CERTIFICATE
of EXEMPTION
DE E W R
8 O FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
, of
9. O Utilities S
Single $
1 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 Building
type of work will be complied with whether specified herein or not. The granting of a permit d es not presume
to give authority to violate or cancel the provisions of any other stater local law regula ' on ruction or the-
Plumbing
Performa ce of construction. �
DATE SIGNATURE Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITI
AEIl.EUI7
NJ --, 03g2
DATE
S: '
6 F— pfiM rT No Plan Check
OFFICIAL
r^^
SEPA
Mobile Home
Other (Specify)
00
TOTAL $ 'f2—:4c
PERMIT NUMBER
DATE_;O�W—Z4
02* *42.00
*4200 U
*42.00
E *0.00
54G220
10-05-79
R 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B COMES;R PE, MIT.
L J J. J
a
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