1979, 10-26 Permit: 79-6769 ResidencePLAN 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
1. � , + I 1 1�a �FNO , LEGAL DESCRIPTION —SEE ATTACHED
2 5T 6:Z IS U �--4-11S I Q N Lr qj��� [�l AV2 r PARCEL NUMBER/S C i'' 3 OZ,nC
OWNER ``�J({j�n PHONE / �J
3.rf-5r?-6338
ADDR SS ZIP Required Set Backs in Feet
K I n 1-/ 1-7 ITf 1=19—Lcl-VI-S I__ I I I
ADDRESS
?ESIGNER
5. ADDRESS
CHANGE OF USE FROM ITO
6.
PHONE
Size of Parcel
7, OF ❑ OTHER
Zi
2assificatio
N
Req'd. Recd. Not Req'd.
ZIP
Type Const.
Occupancy
Sprinklered
❑yes []No ❑ Req'd.
PHONE
Valuation
of
�. Utilities
Building Area in Sq. Ft.
ZIP
OWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
D. .5-27q SIGNATURES /l�f
No Baths
No
Floors No Rooms
Rec Room
PERMIT NUMBER
DATE
02* *2.5.75
*25.75
*2575Y
E *0.00 `.-'-
676.82
10-26-79
6.479,
IYPL �N W ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE
Req'd. Recd. Not Req'd.
/71 of EXEMPTION
WORK
t�A I L ��i �
I _'
FEES COLLECTED
VALUATIO So rce GAS ELECTRIC WATER SEWER
of
�. Utilities
Single $
hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
5
)n reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
:ype of work will be complied with whether specified herein or not. The granting of a permit does not presume
:o give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
Plumbing
D. .5-27q SIGNATURES /l�f
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: l
DEPT. REQ'D. RECD.(�
Plan Check
Env. Health
1�=::%f. /V, t� /�✓
SEPA
7�t���1`.t.
Planning ��t�jT✓ ,"�C�fi>�
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities_
TOTAL $:C h
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist i )
THIS Bl�COMES A. PERMIT.
DATE OFFICIAL���,/'�,,��Z'�L-'
7 1
*;25.75°i
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