1979, 09-07 Permit: 79-3578 MHPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
DE ROBE WOR.
8 j� . / �D FEES COLLECTED
rci
VALUATION Source GAS ELECTRIC WATER SEWER
of /� Ism r
9, utilities Single $�
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included K
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building JD'
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 local law regulating construction or the
performance of construction. ,
Plumbing
DATE SIGNATURE Z�Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health _
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
DATE/ —/--77 0 F F I C I A I./cd�z�i ,
TOTAL $
` PERMIT NUMBER
? 9 — 7�
DATE 9-7`' 79
02* *50,00
* 50.00 N
357:72
09-07-•79
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
*50.vQn 'r-
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
j�C
LEGAL DESCRIPTION —SEE ATTACHED
�
LOT
I BLOCK
SUBDIVISION .
PARCEL NUMBER/S j� 3— L
2.
Artac
( f
e -
OW ER
P ON
3.
r
a&
ADDRESS
ZIP
Required Set Backs in Feet
,/
1
/
of
North South J�%� East ?L9,% West
CON RACTOR
PHONE
Size of Pycel
02 Q,3�
;Z;,e Classification
La
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes []No ❑ Req'd.
DESIGNER
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.
TYPE ❑NEW ❑ALT.
❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
❑ BLD. ❑ PLMB.
OTHER
❑ MECH: ❑ MHPOOL ❑POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd.
WORK
of EXEMPTION
I
DE ROBE WOR.
8 j� . / �D FEES COLLECTED
rci
VALUATION Source GAS ELECTRIC WATER SEWER
of /� Ism r
9, utilities Single $�
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included K
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building JD'
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 local law regulating construction or the
performance of construction. ,
Plumbing
DATE SIGNATURE Z�Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health _
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Zone Clearance
SEPA Checklist
DATE/ —/--77 0 F F I C I A I./cd�z�i ,
TOTAL $
` PERMIT NUMBER
? 9 — 7�
DATE 9-7`' 79
02* *50,00
* 50.00 N
357:72
09-07-•79
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
*50.vQn 'r-
bmi
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