1979, 10-22 Permit: 79-6453 GaragePLAN NUMBER
1
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. 071 9 _B L"I 'K tut.itsicgq<,;r1E2-4-1�2. 1 pL-a CLAI) Hat 1 1F r
PHONE
ZIP
--;O-W�NEf' I/ L
3. IDD E`ss�_ L7
L
C RACTOR
4. - hP&d (%
ADDRESS
1 I)
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER/S
042-‘Z-T—
DES fGNER
5' ADDRESS
ZIP
912 01
PHONE
Required Set Backs in Feet
j�� rI
North �,� South lLi*:l East c9t West
Size of Parcel Zone lassification
I X 15' EviS/DEN-rihL MOBILE,
Sprinklerect
❑Yes ❑No ❑ Req'd.
Type Const.
rV
Occupancy
aluation_3 Building Area in Sq. Ft.
7CJo
ZIP
DVVL Area
Basmgnt Area Garage Area
CHANGE OF USE FROM
6.
TO
TYPE
7, OF
WORK
%NEW CI ALT. ❑ AD'N.
❑ BLD. ❑ PLMB. 0 MECH.
SCRIBE WOR
8. ll )'LIE
VALUATI N
LOC}.r
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 n.t. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other ate or local I.w regulating construction or the
performance of construction.
14 FIJ
Source
of
Utilities
❑ RPL.
O M.H.
(-1A-e_ter.
GAS
❑ MVE.
O POOL
0 OTHER
ELECTRIC
XhSplit try
a
No. Floo
S1( Level
WATER
ERTIFICATE
of EXEMPTION
SEWER
7 r
Storage
No. Rooms
Reqt.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
�7
, rL�,C
/ 77
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITION
rIAT/9i27
F FFIf`I
3/42 cher
Rec'd.
eeRoom
Not Req'd.
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
79 -
DATE e -15=-7Q
02* *5600
*5600 v,
*56,00
E *0.00 8
6452
10-22-79
2 6479.
—
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
*5 6. 0.0