1979, 10-17 Permit: 79-6127 Storage BldgPLAN 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
2.
JOB ADDRESS
//�7O 4'.r -r Spal 4NE WA,5 // 99.2o6
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
3. a1 4Y 6), '1 e ctn
/g y e2 /V.6--
ADDRESS
Sia "A As Job
CONTRACTOR
4. fAl 4- Co ",-,174,e7 S i 4/
ADDRESS
/.2 a o N. FAAic- //,e S;6)/1.4,✓F /,✓",5
DESIGNER
�4a nn
5.
PHONE
PARCEL NUMBER/S
ZIP
PHONE
533-9v/
Required Set Backs in Feet
North !South J�
Size of Parcel
East S (West
Zo a ClasFification
ZIP
99(26)6
Type Const.
Occupancy
Sprinklered
Dyes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
y3'O
ADDRESS
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
7.
TYPE
OF
WORK
{6t NEW
LZI BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
Fl
CERTIFICATE
of EXEMPTION
DESCRIBE WORK
8. 77L.-- ‘•/,.5 7` ac, Xa 06,09
VALUATION GAS
9.
Source
of
Utilities
No. Rooms
Rec. Room
Req'd.
Rec'd.
ELECTRIC
WATER
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 /.,7 — V SIGNATURE '53.2./ -f
DEPT.
Env. Health
Planning
SPECIAL APPROVALS
REQ'D. REC'D.
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE/ /5 %'OFFIC
APPRI4T FOR ISSUANCE
Not Req'd.
x
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
DATE
rPERMIT NUMBER
rre
02* *38.00
* 38,00 t
* 38.006
E *0,00 0
61262
10-17-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS.,BECOIYIE,S APE(MIT.
0 1 2, 7
*38.0021
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Prof.
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