1979, 12-12 Permit: 79-9006 GaragePLAN NUMBER
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
JQB ADDRESS
1.;y
�l ,
LOT
2.
r'?
BLOCK SUBDIVISIO
LEGAL DESCRIPTION — SEE ATTACHED
OWNER )
3. 3 /.. het. '2 rt. -L1 ii.7cric..r
,ADDRESS
. //L).2'1 1/1ALi_9f-',L' le..4.21d ' p'zLvrlt'
CONTRACTO ,/
4. _jOVsrl L'i{Lf1G(/1. 4
ADDRESS
f
DESIGNER
5. ADDRESS
PHONE
�d,f`1
PARCEL NUMBER/S 2) 5=� L;
, /
0op,,Rr ',v/r..v
Tib 4 tt.
ZIP
PHONE
f/
St a
ZIP
Required Set Backs in Feet
North d",:„1, South sj
Size of Parcel Zone Classificatiqn
. 1P�1 i (�'L .t'l•:. Y. -L(
East Sc.) West
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
PHONE
Valuation d
ZIP
'L Area
Building Area in/Sq. Ft.
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split,
�'es r�
Levef ,
Y
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
O ALT. 0 AD'N. ❑ RPL.
❑ PLMB. ❑ MECH: ❑ M.H.
❑ MVE.
O POOL
DESCRIBE WORK
8.
JALUATION t,) I Source GAS
of
9. fP 4Utilities
,OTHER
�✓n
ELECTRIC f
No. Baths
No. Floors
1
No. Rooms
I
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
WATEfR SEWER
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 or local law regulating construction or the
performance of construction.
DATE JJ—i.i - -
SIGNATURE Zd4fr )4 #
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
&-ee-t-r1-d ///y -2Y
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE / OFFICIALS
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
7�-9'.
DATE
02* *44.00
*4400 tri
*44006
E *0.00 8
90058
12-12-79
2 611.79,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A RE.RMIT. 9 0 0. 6 z
12-12
L
•
ci)