HomeMy WebLinkAbout1979, 10-04 Permit: 79-5255 ResidenceIP
LAN 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
LEGAL DESCRIPTION —SEE ATTACHED
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jl
BL�K
SUBDIVIS�
PARCEL NUMBER/S
2
e
OWNE
PHONE
3.
+ { G
{ V ./
—
ADDRE S
ZI
9
Required Set Backs in Feet �f
Q
/1L/
North 1 South East West �v
CONTRACTOR
PHONE
Size of Parcel
Zone Classificati
ADDRESS
ZIP
Type (;ops
ccupancy
Sprin lered
XNo
V
fe
❑Yes ❑ Req'd.
DESIGNER
'
PHONE
Valuation _
Building Area in Ste. Ft.
1/G11
5.1
ZIP
DWL Area
X52
Basement Area Garage Area
�
Storage
CHANGE OF USE PROM
TO
Split Entry
Split tevei
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
��
TYPE T NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
—5
VA)ri
7, OF/ ❑OTHER
M.H. POOL
BLD. ElPLMB. 1:1MECH: El M.
CERTIFICATE
Req'd.
Recd.
Not R.eq'd.
WORK
of EXEMPTION
I
_J�/
DESCRIBE WORK
FEES COLLECTED
8
VALUATION Source GAS EL CTRIC WATER SEWER
9. G 0 °f
Utilities Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included 15coo
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building '2f11
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 con truction. Plumbing
DATE SIGNATURE_ A d Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
� S Plan Check
DEPT. REQ'D. RECD. e5r \P— PLAN) �d � ;7,t2- SI p�,_
(Vv
Env. Health C
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Cleatlance
SEPA Checklist Ci
DATE
PERMIT NUMBER —�
7 t - �"�-�
DATE�d
02* *21 5.00
*2_1 5.00
*215006
*0,00 S,
5254%
10-04-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. C3 *' ^ ' n
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