1979, 11-19 Permit: 79-8126 Residence1
PLAN 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 AD9AES5
LEGAL DESCRIPTION — SEE ATTACHED
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BL I K
UBDIVISION
PARCEL NUMBER/S rok7v L
2
Other (Specify)
Co. Engineer
AraiI
Vn�j
OWNER
C
PHONE
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3.
ADDRESS %
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ZI
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Required Set Backs in Feet
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(.
North South East West
CONTRACTOR
�A
PHONE
Sizof Parcel
Zone Classification
� x 8
4' ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
I
❑Yes []No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
s.
;53'3 42�)
ADDRESS
ZIP
I_yVL Area
Base en Area G�ge Area
li qj 7(/moi
Cf/1 VSplit
Storage
CHANG'� OF USE FROM
TO
Split Entry
Level
Rancher
6.
TYPE ❑
N ❑ W ALT. AD'N.
❑ RPL. ❑ MVE.
No. Baths
iZ-
No. F�
No. Ro ms
Rec. Room
], OF❑OTHER
CERTIFICATE
Req'd.
I Rec'd.
Not Req'd.
WORK BLD. ❑ PLMB. 11MECH:
1:1M.H. ❑POOL
of EXEMPTION
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8. DESC�21gE �I 'V L,e "I I ` L
I
FEES COLLECTED
VALUATION Source
of
G ERIC ��TER SEWER
j���L
9. O 00 Utilities
%�
V-- vYr `�� Single $
1 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 local law regulating construction or the
performance of construction.
Plumbing
DATE { 6
%li /% SIGNATURE
Mech.
DEPT.
SPECIAL APPROVALS
REQ'D. RECD.
SPE CONDITIONS:
Plan Check
Env. Health
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SEPA
Mobile Home
Planning
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
NUMBER
(��/%0 PERMIT7 7 — 8/-2-�
DATE /l—l9— 7`I
83.00
E xU..C•
01 2 5
11-19_79
/ 9.
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist 1 L D7`IVv THIS B�COMES A PERMIT.
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