HomeMy WebLinkAbout1979, 12-03 Permit: 79-8626 ReroofPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT . .
PERMIT NUMBER
79-3G.zw
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675 DATE ,/".2--.:43 `%1
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
NER
3 A --,1-1/ Pt -t4/ 1 >rJl'C/
ADDRESS
><Y, Q % 2. / (C A-e-PPgaI €4,7- /do -to d a P.,
f1.15,TDR�,�- I-wctt t"
4' ADDRESS
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DESIGNER
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE
ZIP
990,3 7
Required Set Backs in Feet
North 'South East 'West
PHONE
Size of Parcel - 1 Zone Classification
6' ADDRESS
ZIP
99za6
Type Const.
Occupancy
Sprinklered
Dues ONo D Req'd.
PHONE
Valuation 1 Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area r Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
D NEW
❑ BLD.
O ALT.
O PLIAS.
D AD N.
❑ MECH
❑ RPL.
❑ M.H.
Rf dL,,utt, -
GAS
Source
of
Utilities
❑ MVE.
❑ POOL ^ JCA 1--,,
,c OTHER
ELECTRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
WATER
CERTIFICATE
of EXEMPTION
SEWER
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. 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 / — 79
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE OFFICIAL/R21 CH
APPROVED FOR ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single ,
Building / 7�
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ / 711'1°
02* *17.50
* 17.50 Li
* 17.506'
B *Q00 S
86252
12-03-79
2 6479.
CC
0
0
U
- o_
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. '
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