1979, 10-18 Permit: 79-6309 ResidencePLAN NUMBER
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JOB ADDRESS
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OWNER
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ADDRESS
CO TRACTOR
4. AQRESS
DESIGNER
5. ADDRESS
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
LEGAL DESCRIPTION — SEE ATTACHED
SUBSrVTSI01N PARCEL NUMBER/S
PHONE 9
-4/69 ,�OT!r /3�/t I'Ale-A PARK AQQ
} r ZIP Required Set Backs in Feet
�2Q__ y,? North 1A' South / East , West3 v
PHONE Size of Parcel Zo a Classification
ZIP Type Con;Tj Occupancy prinklered
❑Yes ❑No ❑" Req'd.
PHONE Valuation Buildin?O? in S�. Ft. j
ZIP 4
CHANGE OF USE FROM TO
s.
TYPE NEW
7, OF
WORK KBLD.
DESCRIBE WORK
8. A
❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑
❑ PLMB. ❑ MECH: ❑ M.H. ID POOL OTHER
Basement Area I Garage Area Storage
Split Entry Split Level Rancher
%..EVA
No. Baths No. Floors No. Rooms Rec. Room
CERTIFICATE Req'd. I Recd. Not Req'd.
of EXEMPTION I X
FEES COLLECTED
VHLUHI IUN ^/- Source GAS' ELECTRIC WATER SEWER
its-- of
g. ���j Utilities 4- Single $
I hereby certify that I have read and examined this application and have read ,e "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 gr nting of a permit does not presume
to give authority to violate or cancel the provisions of any other state o to al law regulati constructi n or the
performance of construction, �V Plumbing
DATE—� " 7 SIGNATURE SLV Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health 0
J
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:/
DATE/6 7/P--/OFFICIAE-fja,f' CC 6I v{,4Z
JW d/
Plan Check
SEPA
Mobile Home
Other (Specify)
G7 �
TOTAL $
PERMIT NUMBER
DATE f_L)
x r; 6, 0 0 it
6308.
10-18-79
617
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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