1979, 11-19 Permit: 79-8122 ResidencePLAN 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
F DDR ss LEGAL DESCRIPTION — SEE ATTACHED
2 BLACK SU VISION I A -P12 iio� PARCEL NUMBER/S rope �r I r ,} —,207
OWNER
PHONE P
3.
ADDRES
Zlp_
Required Set Backs in Feet, 1
l/
�v I
CSII I
��
North 10 South v E
CONTRRACY R�X
, C/
?
PHONE
Size of Parcel
�z o
4. ADDRESP
ZIP
Type Const.
Occupancy
DESIGNER
PHONE
Valuation
5'
ADDRESS
ZIP
DWL Area
BgSgr�7ept
i ,
CHANGE OF USE FROM
TO
Split Entry
Split I
6.
TYPE N W ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Floors
7
7, OF
❑ OTHER
CERTIFICATE
LLL"'777 BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
WORK
of EXEMPTION
DESCRIJ31E WORK
8. GJ
G C`%
VAL
ATION
Source
GA ELECTRI
WATER
SEWER
� �G/
9.
utilities
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 o ocal law
regulating construction or the
performance off construction.
DATE / �T
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D. ^ REC'D.
Env. Health /O
i
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECT CONDITIONS:
_
DATE 17� �f/"��OFFICIAL�C` A
.ast ;) IWest
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Ar af!/ in SY�lr?q, Ft.
Gara e�'qrP� Storage
.evel Rancher
No. Rooms Rec_Room
Req'd✓�I Rec'd. lNot Req'd.
FEES COLLECTED
Single $
Building 7'��
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
71-
DATE//—/17-71-7
02* *G47.00
pr ` 4 7-
2d
.
*2.0011
{ *0,0 V
81 2 R
11-19-79
6,4-79.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
M Melq sr
13�
saw
1 ��