1979, 09-27 Permit: 79-4819 Residencetr
PLAN NUMBER
2-293-
i
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
ADDRESS
1-
1. JO /% a �41-5/
2. LOBLOCK S
ON
W d, L-6n
e
- /,a1)
ER i•
3. tel,
ADDR SS
/,9 .?c 0. 4 rr4
C RACTOR
4.
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
PARCEL NUMBER/S 73,354/ — 9a'3
LDT Z /31-K 4
M/D/LOMg isr A on
ZIP
H,20
RewireehSet Backs in Feet
r
North % 0 7 'South p / [East 'J 5 , (West 3L%
Size of Parcel
ADORES
ZIP
Type Const.
VN
cup!
Zone Classification
2AN+.Cf-CP i g,(2.4.1E/
ffs,/pr'lnklered
DYes !Vigo 0 Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuati n
' "lP 5-D0'o
Building Area in Sq. Ft.
/ (0......
ZIP
CHANGE OF USE FROM
6.
TO
DWL Area Basement Area
aft 105/1
ft
Split
Garage Area
-trate
Storage
Split Level
Rancher
7.
TYPE
OF
WORK
NEW 0 ALT.
BLD. ❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Floors
No. Baths
CERTIFICATE
of EXEMPTION
/
No. Rooms
0
Rec. Room
Req'd.
Rec'd. -
Not Req'd.
DESC IBE WORKn
8. n� fXPiCC2J
VAL o
Source
of
Utilities
GAS
ELECTRIC
WATER
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 II w regulating construction or the
performance of construction.
DATE`/--/
SIGNATURE
\ id
DEPT.
SPECIAL APPROVALS
REQ'D. RECO.
Env. Health Cf
/_--" �ic{a/2irLe,—
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CGNDITIONS:
1 d i f%tar.g.
DATE
-29 OFFICIALS'-"""-/
APPROVED FOR ISSJJ ?NCE
- -FEES COLLECTED
Single $
r
Building
.�..a��
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
79-415)14
DATE ` -2.7 ZR
02,* *26500
*26500 sn
*265006p
B *0'00 8
48t8fi
0'9=271179
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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