1979, 10-04 Permit: 79-5343 ResidenceNUMB-ERe..
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APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (5091456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
Lor 56Co SUeMXHN
LL
LEGAL DESCRIPTION - SEE ATTACHED
2.
OWNER
3, 141 GCT 1 M &crrOM Cn N S112NCTDN
ADDRESS
is I47T91 SfnicAt4t
CONTRACTOR
SAME
ADDRESS
PHON Ezi5i-6_ %viz
921-1-15B
PARCEL NUMBER/S IG JC{I..I_ 023G
T1}E E. 135' or THE N. IIS' Or TEM SW*
OF TRACT S OPPOP-rUnny, SEC. /6- ZS- to -
ZIP
`19'2 I SL
PHONE
ZI P
5.
6.
DESIGNER
PHONE
ADDRESS
CHANGE OF USE FROM
ZIP
Required Set Backs in Feet/
North Ss ISoutb20 East "74,l p Iwest 6c5
Size of Parcel Zone Classiflca on
X I3 1 CLL.'
Type
Type Const. Occupancy Sprinklered
V -N C_3 ❑Yes DNo ❑ Req'd.
Valuation 00 Building Area in So. Ft.
4f34fit000 "Fr 970
OWL Area Basement Area Garage Area Storage
77o - 59 8 o --.
TO
Split Entry
Split Level
3-L
Rancher
7.
TYPE
OF
WORK
,.NEW
!tT BLD.
❑ ALT.
❑ PLMB
❑ AD N.
❑ MECH
❑ RPL.
❑ M.H.
O MVE.
O POOL
0 OTHER
No: Baths
•1
No. Floors
1
No. Rooms
5
Rec. Room
NoWE_
• CERTIFICATE -
of EXEMPTION
Req'd.
Re 'd.
Not Req'd.
.•I DESCRIBE WORK
(% $ h,'.(-,_
RasNc F� J -NO EckSlt AftpAr r
// VALUATION
/ 9. X34 000 - oc
Source
of
Ut 'blies
GAS
ELECTRIC
a a
WATER
SEWER
EPT1
I hereby certify that I have read and examined this applica ion and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correc . All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of -permit does Ot presume
to give authority to violate or cancel the provisions of any other state or local law r gulating • .n� tion or the
performance of construction.
DATE SIGNATURE
cosi— rile 4_,Atiel
DEPT.
SPECIAL APPROVALS
RE 'D. RECD.
Env. Health
(/ /`-CG-c&, /0/Z/.7?
Planning q
/o/i /7ei i 41 tali
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SE A Checklist
SPECIAL CONDITIONS:
FROWEAccE- REQutPEMEp --
vE —107- 78
Rlw=So'
DATE OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building eit //271X
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ -2//
ef
PERMIT NUMBER
-71 s3 y_3
DATE sFP-r S 16,74
02* *211.00
*211.00 tz
*211.00e
E *000
5342
10-04-79
6479.
.
0
— Ca
LU
0
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1!0'„0'4-t,79 53432 02,1120;0 le
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