1979, 10-29 Permit: 79-6873 GaragePLAN NU BER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
CV
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1.
2.
3.
4.
JOB fOR,ES1O 4- ISI — r- IQc7
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
v5isfrci2Nz 04\17 -Az.
OWNER
rft INN (
ADI V S 0-4- r zt AV
CONTT1
g9D-7
PARCEL NUMBER/S
i� 641-1-
;394e2-7
41-(-
Required Set Backs in Feet
North (South East
(West �O
PHONE
Size of Parcel
ADDRESS
ZIP
i.Zone CI ssification
Type Const. I, Occupancy Sprinklered
Oyes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
ADDRESS
ZIP
DWL Area Basement Area
CHANGE OF USE FROM
6.
TO
Split Entry
Garage Area
if3.67t.
Split Level
Storage
Rancher
TYPE
7. OF
WORK
❑ NEW ❑ ALT.AD N.
I� BLD. ❑ PLMB. 0 MECH:
❑ RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DE C I E W RK
8. - VIZI -ro 5xt , 5r:112r31•46 (4,,
A R
VAL,JATION W TE SEWER
a � BOO
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 granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state o local law regulating c nstruction or the
performance of construction.
Source
of
Utilities
GAS
ELECTRIC
DATE /'/— c / — 7 / SIGNATUR
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
geia4vize)--
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL cpNDITIONS:
i S ff//��
A
Pc_.(s d lC �r
DATE /4''2. `" - OFFICIAL k- 414
nnnnn,,rrs ror 10011A AIrE
FEES COLLECTED
Single
Building ✓_([
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
02* *5000
*5000
687.28
10-29-79
2 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS,BgCOpIFnS. ARFhRMIT.
68'7,35 *50.00.2if
25'
PP--oci,efss
LE041. t),5aRtPrrop) -s VE RADA LE le4 ttg. Ler
N /0.21 0,063.02ECS
B 3
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