1979, 09-21 Permit: 79-4450 Duplex- _,,N NUMB17R
JOB ADDRESS
LOT BLOC
2
OWNER (�
3. ��
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
I Nf PARCEL NUMBER/SS j �Lo2
PHONE C -J
I-z-lp-
]Required Set Backs in Fee
No. Baths No. Floors No. Room Rec. Room
TYPE IX NEW ❑ ALT.
El
TYPE El RPL. ElMVE.
7, OF 11 OTHER
WORK BLD. ❑ PLMB. ❑ MECH: ❑ M. H. El POOL CERTIFICATE eq'd. I Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
ny_,��. ,n
8. h'w Y-9 � .�r7k ,L 7 l� �!
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities ��'���'i( LCA 5T7
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 i SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D.
RECD.
Env. Health
I
Planning
C
�1C
t- Z j
North South
East V West
CONTRACTOR ��
PHONED _y-i.2j
Size of Parcel
Zone Classification ,u
ry
c; TV X
7(� 2--
4' DDRESS z
ZIP
Type Const.
�?
Occ pancy
SStprinklered
-cl
Y �L_
❑Yes NNo ❑ Req'd.
DESI NER -- ----
—
PHONE
Val t,
Building Building Area in S�q..^Ft.
5.
ADDRESS
ZIP
DWL Area
Braseement Area
Garage Area
Storage
/11
CHANGE OF USE FROM
TO
Split Entry
Split
Level
Rancher
6.
No. Baths No. Floors No. Room Rec. Room
TYPE IX NEW ❑ ALT.
El
TYPE El RPL. ElMVE.
7, OF 11 OTHER
WORK BLD. ❑ PLMB. ❑ MECH: ❑ M. H. El POOL CERTIFICATE eq'd. I Recd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
ny_,��. ,n
8. h'w Y-9 � .�r7k ,L 7 l� �!
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. Utilities ��'���'i( LCA 5T7
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 i SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D.
RECD.
Env. Health
Planning
O
�1C
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SPECIAL CONDITIO
0
SEPA Checklist I
DATE OFFICIAL- L
nnnnniirn rnn 10011 A ninr
FEES COLLECTED
C� PERMIT NUMBER
DATE
02* *28300
*283,00 10
*283.00
A *000 00
444,9
09-21-79
2 6479,
Single $
d� —
Building -1 g
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ � =8
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS Bl�OMES A PERMIT.
,� , .a� • �
,—., _
�' ���
� .,. _
,., ..
1. N.. "
OFFICE 0f TME
SPOKANE COUNTY PLANNING DEPARTMENT
Dore ,19�
Buildinq Codes. Department _
Planning Department ---
ct_- Buildinq_Permit
0
The Pjanniing Department has received a request from
for the release
of a building permit on the property as described on
the attach d affidavit/legal description. It has been
determine that a building permit should be issued
under the provisions of RCW 58.17.210. This memo
and attached affidavit/legal description must accom-
pany the building permit application.
��e., � . aid` � l � � � • S � . fie, � • l 00 `
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4
A
A
y
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