1979, 09-28 Permit: 79-4922 AdditionPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. M �Arrild K
LOT I BL CK
2.
Z
SUB �ISIONf0 /C07
7-izktz- 5a8
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3 .105/ -pe -1- %Z . 4 e-gl»flRR
ADDRESS
M CAfall 02
4.
N /c907
C NTRACTOR‘3 CHOSTC
PHONE
PARCEL NUBEMR/S
1754z—I32f
Lor 7, YsucoK 2i PIR-
G ProgTo/..TV
92B. P7'-'•
ZIP
912(26.0
Required Set Backs In Feet
c
North 2✓-) (South 7i5— East
S- (West
PHONE
Size of Parcel
Zone Classification
,1&,v, Sc43.
ADDRESS
ZIP
Type Const.
f/0G
re—
Occupancy
Sprinklered
Oyes ONo ` Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
/44
ADDRESS
ZIP
DWL Area
Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Spilt Entry
Split Level
Rancher
7.
TYPE
WORK
O NEW
❑ BLD.
O ALT.
❑ PLMB.
MAD N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors
/
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8...GDP c.c.) &t'e T2M
VALUATION
9.
z 000
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 egulating construction or the
performance of construction.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
SIGNATUR
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
gd 77%64/79
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
j'I,fiaJ s ArN 0 - Cts 1
NMC, a) oWtik a
DATE
OFFI
APPRSVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
4c, 00
Mech.
plan Check
SEPA
Mobile Horne
Other (Specify)
TOTAL $
PERMIT NUMBER
79 — 452447
DATE
02* *3200
*3200 tz
*32006
B *000 6
477.33
09-26-79
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THISICOIj(IEPgS A r 1MIT.
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