1979, 09-28 Permit: 79-4973 GaragePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
8 �� C'/it��'� FEES COLLECTED
VALUATION ( Source GAS ELECTRIC WATER SEWER
of
Utilities
Single
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 Building
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 or I al law regulating construction or the
performance of cons ruction. - Plumbing
1,2
DATE ` / ! SIGNATURE L Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Carr l` 7%
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
1?v-41--'5 0K L,l ?,
DATEw1 OFFICIAL L
Plan Check
SEPA
Mobile Home
Other (Specify
TOTA L J $
PERMIT NUMBER
DATE -:7 —
* 1 7,00
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
�0
497,2-5
09-28-79
6479,
APPLICANT:
COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
A-✓ 162-1
LEGAL DESCRIPTION - SEE ATTACHED
1.
LOT
BLOCK
PARCEL NUMBER/S G7
2.
I
ISUBDIVISION
N(oo. ,3F7-00- ivic+s tom' F7- aG
AE6.4SP°7' aF Dj-/< .31 /' Y►'L UK�iT�I
OWNE
ONE5
3.
ADDS
ZIP
Required Set Backs in Feet
/>
North jSo.th East West
C N
PHONE
Size of Parcel
Zone Classification
4.
A[5Dl4FSS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes E] No �81` Req'd.
SIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
I
TYPE ❑NEW ALT.
1-1AD'N. El RPL.
ElMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ OTHER
CERTIFICATE
Req'd. I
Recd.
Not Req'd.
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
of EXEMPTION
8 �� C'/it��'� FEES COLLECTED
VALUATION ( Source GAS ELECTRIC WATER SEWER
of
Utilities
Single
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 Building
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 or I al law regulating construction or the
performance of cons ruction. - Plumbing
1,2
DATE ` / ! SIGNATURE L Mech.
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Carr l` 7%
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
1?v-41--'5 0K L,l ?,
DATEw1 OFFICIAL L
Plan Check
SEPA
Mobile Home
Other (Specify
TOTA L J $
PERMIT NUMBER
DATE -:7 —
* 1 7,00
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
�0
497,2-5
09-28-79
6479,
,Z7