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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