1979, 09-19 Permit: 79-4268 GaragePLAN 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
AD
rADDRESS
5 55
1.
SUBDIVISION
LOT
2.
OWN /
A DRESS �V/
Sdo ///71 "e -
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
COlsf%R ACTOR
4.
5.
A DpRE5$i,
DESIGNER
ZIP
PARCEL NUMBER/S 0 71/45Yy - O bo
Required Set Backs in Feet s•
North (South IVO East 75
(West / ]�
PHONE
ZIP
PHONE
Size of Parcel
Ty a ons Occupancy
L
alua oers
ADDRESS
ZIP
D W L Area
,
Basement Area
ne Classification
-S�bti� l
Sprinklered
Yes No 0 Req'd.
Building Area in Sq. Ft.
-9Go
Garage Area
Store
ge
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
DE i1'IFI WOR
8.
9.
ixNEW
A BLD.
VALU TION
S9,
❑ ALT. 0 AD N. 0 RPL. 0 MVE.
❑ PLMB. ❑ MECH: 0 M.H. 0 POOL
I
Source
of
Utilities
GAS
0 OTHER
ELECTRIC
No. Baths
No. Floors
No. Rooms
Rec. Room
WATER
CERTIFICATE
of EXEMPTION
SEWER
Req'd.
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 nting of a permit doe of presume
to give authority to violate or cancel the provisions of any other state o4tji I law regulating c. /uction or the
performanc- '.f construction.
DAT
DEPT.
1-7/
SPECIAL APPROVALS
REQ'D. REC'D.
SIGNATURE
Env. Health
Planning
.t Ve/y 97P/7y
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
v
SPECIAL CON �IONS: •
T) A//aCked
DATE I/77-/ OFFI C IAL4311{4}
APPROVED FOR ISSUANCE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $ �,[(p
Building )E/'8
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
%`7-11268
DATE 9-11-
02*
*oaoo
*6aoo N
*69006
8 *Q00
42672
09,=1.9'-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS COM APERMIT.
(��f-'! f- 719.
42`6.8 z
*68.0,0,2P'
CC
0
w
0
C./3