1979, 10-16 Permit: 79-6061 AdditionPLAN NUMBER
- 37D
JOB ADDRESS
3.
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
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVIS ON PARCEL NUMBER/S
PHONE
ADDRESS
ZIP
Required Set Backs in Feet
North ? South "�"r East 3 West
CONTRACTOR
PHONE
Size of Parce}
Zone Classification
4.
ADDRESS
ZIP
Type Const.
Occup ncy
S rinklered
Y
�'
3 .
❑Yes NNo ❑ Req'd.
DE SIGNER
PHONE
Val tion
Building Area in Sq. Ft.
1/4,
Op
aao
5.
ADDRESS
ZIP
DWL Area
Basement Ada
Garage Area ,
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Levef
Rancher
6.
TYPE ❑NEW ❑ALT. AD'N.
❑ RPL. ❑ MVE.
No. Baths
No. Floors
No. Rooms
i
Rec. Room
]. OF
El OTHER
11BLD. ❑ PLMB. ❑ MECH:
❑ M.H. ❑ POOL
CERTIFICATE
Req'd.
Recd.
Not Req'd
WORK
of EXEMPTION
`J
DES�RIBE WO K
.
IV;
8.=t_
L I
FEES COLLECTED
Z Lr`
_`-
VA 4JATION
Source
GAS
ELECTRIC
WATER
SEWER
S.�Q O
9. 00 -n --
of
Utilities
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
vJ
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 reg lating cgnstruction or the
performance of construction.
^
Plumbing
DATE %L/.�J/_ i
SIGNATURE_
!
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
t �
Co. Engineer
Other (Sp�Ci�Fy)
Utilities
TOTA L $ / ,:7;, ,
Zone Clearance
Checklist
1�
DATE OFFICI
0 JPRMJT NUMBER
DATE
02 * * 1 79.00
* 1 79.00 O
* 1 790001
E *000 C
606,02
10-16-79
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
/ r " THISEl —tI—P OM E S 11T.
%2r� %llt z c iJ o. i * 17 9.0.0
5 J0TH rziv�RwAy