1979, 09-18 Permit: 79-4168 ResidencePLAN NUMBER
1"q
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESC IBE WORK
�' FEES COLLECTED
8. p� ��. �. CS 6ar -
VALUATION v� source GAS ELECTRIC WATER c SEWER
9. (� C�. utilities s
Single $
f hereby certify that I have read and examined this application and have read the "NOTICE" provisions included D
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 local law regulating construction or the
Plumbing
performance of construction.
,
DATE (�r�� — 7 /r
SIGNATUR r Mech.
SPECIAL APPROVALS SPECT CONDITIONS:
DEPT. REQ'D. RECD. �' %� /!l // Plan Check
Env. Health e ! , o-i� I ` S Z{% s l � j 0- V Q
r" V ? SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
PERMIT NUMBER
DATE
02* * 1 21.50
* 1 21,50
* 1 21,50
A *000
41 6,7;?
09-18-79
;? 6479,
Utilities
TOTAL . $
arance
% WHEN MACHINE VALIDATED IN HIS SPACE.,
:klist
THIS BECOMES A PERMIT.
�., � - � ]
�" %,����'�,� 09 l
DATE OFFICIAL 16.8d- *121.50°-J
��._
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1.
J ADSS
T, 1DRERE y
s 1,4?LEGAL
DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
%��
��
PARCEL NUMBER/S C
/ Z ZCiOt /
2.
OWNE
3.
B
ADDRESS
Z P
Set Backs in Feet
/
� J,
//
:;IL,) -'0
U
%
L�
North South +.J=J East West
C TRACTOR
PHONE
Size of/Pa el_/
Z ne Clas fication
�')V
Gly
Al. �.
4.
ADDRESS
ZIP
TypeCgnst.
Occupancy
Sprinklered
Irl//
Dyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuat4&
Building Area in Sq�t.
5.
ADDRESS
ZIP
DWL A
Basement Area
Garage Area
S�t%rage
CHANGE OF USE
FROM
TO
Split Entry
Split Level
Rancher
6.
TYPE [g NEW
❑ ALT.
11AD'N.
ElRPL. 1:1MVE.
No Baths
No. Floors
Nyooms
Rjc. Room
],
OF
❑OTHER
IX BLD.
El PLMB.
MECH:
❑ M. H. ❑ POOL
Req'd.
Recd.
Not Req'd.l
WORK
of EXEMPTION
I
f—
DESC IBE WORK
�' FEES COLLECTED
8. p� ��. �. CS 6ar -
VALUATION v� source GAS ELECTRIC WATER c SEWER
9. (� C�. utilities s
Single $
f hereby certify that I have read and examined this application and have read the "NOTICE" provisions included D
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 local law regulating construction or the
Plumbing
performance of construction.
,
DATE (�r�� — 7 /r
SIGNATUR r Mech.
SPECIAL APPROVALS SPECT CONDITIONS:
DEPT. REQ'D. RECD. �' %� /!l // Plan Check
Env. Health e ! , o-i� I ` S Z{% s l � j 0- V Q
r" V ? SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
PERMIT NUMBER
DATE
02* * 1 21.50
* 1 21,50
* 1 21,50
A *000
41 6,7;?
09-18-79
;? 6479,
Utilities
TOTAL . $
arance
% WHEN MACHINE VALIDATED IN HIS SPACE.,
:klist
THIS BECOMES A PERMIT.
�., � - � ]
�" %,����'�,� 09 l
DATE OFFICIAL 16.8d- *121.50°-J
��._
40,
I