1979, 07-20 Permit: 79-801 ResidencePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARP TO MAKE 4 COPIES
JOB ADDRESS
1. T riLOK
2.
/
/am ch rgai
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION
PEPUN %5K 1 S FIRST" Ann 1Tlcnl
PARCEL NUMBER/5 PTN OF 01St''/- / 00 1
OWNEROW////
3, 62P n/P_ ?YO/2.7e S
ADDRESS
/5929 ,E, SFI-ascce g✓e_
CONTRACTOR
4 /hani/s M, X/ao%den
ADDRESS
/2,929 .E. S/wit
DESIGNER
6' ADDRESS
PHONE
/99/
PHONE
9 -/999/
ZIP
99.-/4
PHONE
ZIP
Required Set Backs In Feet
North EXIST" 'south6)(13TEast nis-r-'West nen
-
Size of Parcel Zone Classification
//o X yo SINGLE FAMILy res
Type Const. Occupancy Sprinkleretl
V -N p.,-3❑Yes DNo 0 Req'd.
Valuation Building Area in Sq. Ft.
0 -- 24/4
DWL Area Basement Area Garage Area Storage
1976 /�i76 `f `for
CHANGE OF USE FROM
6.
TO
TYPE
7. OF
WORK
❑ NEW
BLD.
❑ ALT.
❑ PLMB.
D AD N.
O MECH:
❑ RPL.
❑ MVE.
O POOL
® OTHER
W .neiNa/
Split Entry
No. Baths
/
Split Level
Rancher
No. Floors
/
CERTIFICATE
of EXEMPTION
No. Rooms
5
Rec. Room
ND E
Req'd.
Recd
Not Req'd.
DE CRIBE WORK.
8.Res,'o'enre./Ca-raac g# ,%..»
VALUATION SourceGAS
of -
9. —0— Utilities
ELECTRIC
rs
WATER
SEWER
Se p
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 governg this
type of work will be complied with whether specified herein or not. The granting of a permit does not pr ume
to give authority to violate or cancel the provisions of any other state or ISI law regulating cgnstruction o the
performancy of onstructiyn.
S2 O 79
DATE
SIGNATURE LV1/U14'1a-1
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
lenaet/ of '�eAin ;f
No. M- 6023
Re -c? FEE. x/07 �xx
DAT 0-2'-79 OF FICIA Ler'r .4' A:24.4644
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building S /67
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
50
TOTAL $ /D7'ta
PERMIT NUMBER
7? -8o1
DATE 3144 z0/1q'19
02* *107.50
* 107.50
* 107.506
6 *a
8002
07-20-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
077207.79 80,15 *107.5.0°rj