1979, 10-17 Permit: 79-6133 GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDIAG CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. &: //tzar, /.4,14 cQt SideAnss WAs%' 992o6
LOT BLOCK SUBDIVISION CC
2. 5 3 A.CCNA •]E COM 4'/ diell' e)zJ
3. DY.c y fio
ADDRESS
SAMF$4•5 )06
CONTRACTOR / �" OJ ,p 4 A
4 y 3 wnt 9� Cot/Arley ey .�Ttt,/ .5
ADDRESS: , /
/.2 a 0 N. FAe c /r &S /P0,441.5, 44S f/.
OESIGNER
SA Ale
ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
9asr /ga5-
5.
ZIP
PARCEL NUMBER/S 335¢x. _7505
PHONE
.5135-0/0/ 6
Required Set Backs In Feet
II'I
North 7 South East -2(62f/ I West 20
Size of Wel Zone Ci ass fr ication
ZIP
c9avd
T
40 k3 c 4L�? %l14I1/
Type Const. Occu pd ncY Sprinkle ed
❑Yes ONo 0 Req'd.
PHONE
ZIP
Valuation Building Area In Sq. Ft.
7
OWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
7.
TYPE
OF
WORK
13 NEW 0 ALT. 0 AD N. 0 RPL.
BLO. 0 PLMB. 0 MECH. 0 M.H.
DESCRIBE WORK
8. CO a4/xay 6A,e019.E
_AIVALUATION
s: 3 5e=
Source
of
Utilities
GAS
❑ MVE.
❑ POOL
0 OTHER
ELECTRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
WATER
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law rnegulating construction or the
performance of construction.
f -as= 7c
DATE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE 10 i,
APD FOR ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single -$
4 38,00
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE
02* *3800
*3&00
*3&O0�
E *0'00 8
6'132
10=17.-79
A 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISI659O1yll6flF,.fiMIT.
611'3:3'1 *38.002.8
CC
0
C.3
0-
Z
Eft c y
,E // 2-20 Nail A Cad
Sea �ta ��, L✓As hr. 99.20G
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PArc.,e 33 2 - aS S
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