1979, 12-07 Permit: 79-8818 FurancePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
4G - PERMIT NU—MBCTE/R /
DATE
04* * 1 4.00
*14.00
*14.00
E *0.00
88 L7
12-07-79
R 6.479,
VALUATION Source G ���EJJJ E TRIC WATER SEWER
of j j(
9. Utilities v ` 1 1 Single $
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 Building
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
Plumbing
performance of construction.
DATE/�'J / % SIGNATURE` & Mech. �
SPECIAL APPROVALS SPECT NDITIONS:-
DEPT. REQ'D. RECD. Plan Check ]_
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
t.�
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE Z— _7 OFFICIAL
ADDDn%/Gr1 COD IQQIIANIr`C
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 -COPIES
JOB ADDRESS
>SSp
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK
PARCEL NUMBER/S
2.
ISUBDIVISrON611
OWNER
PHONE
3.
r
a
ADDRES
ZIP
Required Set Backs in Feet
North South East West
CONT44ACTOR
P NE
��
Size W Parcel
Zone Classification
Wit✓-
-9a0
4'
ADDRESS
.
�V1
�'t,i:�
,�-y
Type Const.
Occupancy
Srinklered
p
!QQ /
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE
FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE 11 NEW
ALT. AD'N. ❑ RPL.
El MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
❑ BLD. ❑ PLMB. �MECH: ❑ M.H. ❑POO
WORK
of EXEMPTION
DESCRIBE R
8
FEES COLLECTED
4G - PERMIT NU—MBCTE/R /
DATE
04* * 1 4.00
*14.00
*14.00
E *0.00
88 L7
12-07-79
R 6.479,
VALUATION Source G ���EJJJ E TRIC WATER SEWER
of j j(
9. Utilities v ` 1 1 Single $
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 Building
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
Plumbing
performance of construction.
DATE/�'J / % SIGNATURE` & Mech. �
SPECIAL APPROVALS SPECT NDITIONS:-
DEPT. REQ'D. RECD. Plan Check ]_
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
t.�
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE Z— _7 OFFICIAL
ADDDn%/Gr1 COD IQQIIANIr`C