1979, 08-10 Permit: 79-1969 Residencede
PLAN NUMBER
c
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 '�'j
ADDRESS�.
LOT I I BL CK
2
SMV IrfW w-
flt$lw 11*1 Aprnl or -4
LEGAL DESCRIPTION - SEE ATTACHED
N
ADORES
colt/ a2 1110 •
zo 9riAl cV
PH'I VE773 /
ZIP
200
PARCEL NUMBER/S
69 — 0703
4.
CONTRACTOR
ADDR SS
PHONE
Required Set Backs in Feet
Northbtjd South3 0
Size of Parcel
ZIP
DESIGNER
PHONE
TAConst.
Valuation
Occupancy
East 3 (West I7
Zone C1 ssiflcat lan
fl _ Sprrii-nklered�
Eye s ❑No 0 Req'd
BuiIding/Arrea in Sq. Ft.
ADDRESS
ZIP
CHANGE OF USE FROM
6.
TO
�WA,r,f a Baseme t Ar
0 NIF)
Garage Area
Storage
Split Entry Split Level
Ranche
TYPE
7. OF
WORK
12{NNEW 'D ALT.
(Itl BLD. 0 PLMB
❑ ADN. 0 RPL. 0 MVE.'
O MECH: 0 M.H. 0 POOL
0 OTHER
No. Bath
No. Floors
NO.. 00
Rec. Room
CERTIFICATE
of EXEMPTION
Reg d.
Recd.
Not Reg d.
DESCRIBE WORK
8.
VALL�VA5 I
~
9. 600
�
So ce
of
Utllitles
GAS
ELECTRIC
WATER
I C
SEWER
--Irl'Ytz
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 constructer or the
performance of construction.
can
DATE `- 17- 79
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
r�zlci 741/2 i
Planning
i
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
Cofer/(3S Cid
DATE
APP FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE
02* *5Q00
*5Q00 17)
*5Q006
E' *Q00 8
19683
08=10=79
2 6479
S
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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