1979, 10-05 Permit: 79-5399 Renewal Permit GaragePLAN 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
2.
l7
OT BL CK SUED VI IO
6 REEA)
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3 CRoSBy ENTEIZ_PRISF�
4.
PHONE
2-2.ob
PARCEL NUMBER/S 34.0.#34,.—oIfo This N• 8O'
of THE S, S�f7'1 ` o� 'T14E. E. jrf7.' OF,
?peel" 105 1:1-A1" N0, L, I%tST FP A 5
1 RR. 'lkRcT'S'
ADDRESS
N _ l Sod PINES g. -c) snokrie
CONTRACTOR
ZIP
' q 20
Required Set Backs in Feet
North +!( 'South
East 'West
PHONE
Size of Parcel
8o X 1 Ts/
ADDRESS
ZIP
Type Const. Occupancy
t N 12.-3
Zone Classification
fit RfcuL�ifRAL
Sprinklered
❑Yes 0 N 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
Is6F
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
❑ NEW
O BLD.
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH:
O RPL.
O M.H.
O MVE.
❑ POOL
0 OTHER
No. Baths
1
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESC
8. - G g A 6E,, A -T -TA G N P
VALUAT ON Source GAS
of
9. "O Utilities
— /ZEN4E � n,� IP rr
ELECTRIC WATER SEWER
FA
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 regula construction or the
performanceof co struction.
DATE
DEPT.
SPECIAL ' PPROVALS
REQ'D. REC'D.
SIGNATUR
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
gF•NEW>
N1 0353
EwMrt Na
DATE OFFICIAL
FEES COLLECTED
Single $
Building
4-2-
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
79-5'-399
DATE _ tf,77
02*
*42.00
* 4200
* 42.00
E *000
539.83
10-05-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1 f C . —U>— 7 l7 (1
*42.
INICPCrTnD