1979, 10-04 Permit: 79-5360 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
JOB ADDRESS
1. g_ /92o2 /`//55/Oi0
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION
2. 2 / acia0 AbD 4"7/e ctES
OW7 NER en P,�H�-01/N/E
C/` -
3 titheRV /Zees
ADDRESS
�. /92c2— /C6i:5/0ti1
£tb
NTNT RA
4' ADDRESS
C. 4205 C_oA)67tEt Z
ZIP
P RCEL NUMBER/SPA/ 0 \s) "..2.0/ // 71- _]•_/ 2
/'755 .Z —O/S 7 -(P v.vi
cc tn. 27 t ry • /9.7 s Cor ZS BO< r
C*C.e/.0 ana 76 &Zen) fier-ES
Required Set
ttlBacks in Feet
�{}'
North 11 0 ISouth3O/ (East
I3 IWest 7&
PHONE
62C/-67/6
Size of Parcel
//9.7x 4/./cp 6
Zone Classification
T e Const. Occupancy
7 �tGE
�
Sprinklered
❑Ves ❑No 0 Req'd.
DESIGNER
•
PHONE
Valuation
6390 C_
Bwlding�ea in Sq. Ft.
611
• ADDRESS
ZIP
DWL Area 'Basement Area
Gge^rea
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
NEW
BLD.
❑ ALT.
❑ PLMB
❑ AD N. 0 RPL. 0 MVE.
0 OTHER
0 MECH: -D M.H. • 0 POOL
No. Bath
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DES IBE WO K
8. r/LCL aa2mcr/e- 6i9-2/9<-7
VALUATION Source GAS ELECTRIC
9, 63'?O. n b Utilities
WATER
SEWER
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 ranting of a permit does of presume
to give authority to violate or cancel the provisions of any other state r 1 cal law regulatirncons tion or the
performance of construction.
DATE
DEPT.
SPECIAL APPROVALS -
REQ'D. REC'D.
SIGNATURE
Env. Health
/o/z/7 f
Planning
/
Fre Marshall
Co. Enginee
ULlitie
Zone Clearance
SEPA Checklist
SPECIAL C NDITION
DATE OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
$
s ,pO
TOTAL $
PERMIT NUMBER
""/
DATE /D-4-7�/
02* *560'0
*5600
*5600
E *000 8
53593
•10.04-79
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
101.00,411-7'9 513'6.02 *56010
•
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