1979, 10-04 Permit: 79-5253 Residencei
PLAN 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
W3S LEGAL DESCRIPTION — SEE ATTACHED
.LOT BLOCK SUBDIVISION PARCEL NUMBER/S MCI
04 61'
2.
OWNEI;
3. Iii-//��jj
ADDREISS //ll
CONTRACTOR
—�
4.
ADDRESS� 6
DESIGNER
5. ADDRESS
6.
M
PHONE
74-7-
SPECIAL
47
PHONE
ZIP
PHONE
ZIP
TYPE [�yN/EWEl ALT. ElAD'N. 1-1RPL. ElMVE.
% WORKElPLMB. ElMECH: ElM.H. 11 POOL
El OTHER
LD.
equired Set Backs in Feet
orth South
East I West30
ize of P4rcel
Zo a Classificati
Type Const.
Occupancy
Sprinklered
e
Dyes 5!No ❑ Req'd.
alu tion
Building Area in Sq. Ft.
4� 606 20
83�
DWL Ar Base Ara
Garage Area
Storage
5� g gI
Split ntry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
1
&)/V
CERTIFICATE
Req'd.
I Recd.
Not Re
of EXEMPTION
VALUATION Sour a I✓GAS 'CJ ELECyRIC T SEWER
of 1 A / �
9. .3 ��� utilities �1vt w Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included C2
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 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. Plumbing
DATE /s �F SIGNATURE-, Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health',
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONq ITIONS:
(✓V��L SU���i�(J� �� Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
j WHEN MACHINE VALIDAI
/ THIS BECOMi ES A PERMIT.
� I n s i)
r PE -I� UE�
DATE�d —4— 7g — 7?
02* *215,00
*21 5,00
*21 5.00:
*0,00
525,229
10-04-79
29 6,479,
IN THIS SPACE,
Gi-rA&AI *F-NRGri-