1979, 09-17 Permit: 79-4121 Garage, Renewal of N0535 PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBE
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
02 * * 2000
JOB ADDRESS 1. C-- ,/2(i) 111 41- LEGAL DESCRIPTION - SEE ATTACHED * 2 Q 0 0 lz
LOT BL�CK SUBDIVISIOPARCEL NUMBER/S 0?_,..3 5 ✓ ,4 p / * 2 Q Q Q
,2. Q /1./e 1 d1/'.t: ,.,✓
B * 000
'NER PHONE
3. r 0X ,5td� S �� .315,2 4 1 2 0
ADD ESS �"/� ZIP / Required Set Backs in Feet �7
,is f- '/ T 6 404 ?q,2 06 North 'South East West 0 9— 1 I —7 9
CONTRACTOR F� 11�� PHONE Size of Parcel Zone Classification
'ox/� 2 6479.
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
7(9 .t)
5' ADDRESS ZIP DWL Area I Basement Area Garage Area Storage —
7 l
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. 0 AD'N. ❑ RPL. 0 MVE.
7, OF ❑ OTHER -
CERTIFICATE Req'd. Recd. Not Req'd.
WORK CI BLD. Cl PLMB. CIMECH: 0 M.H. ❑ POOL
of EXEMPTION
8. �ESCRIBE WOJIK FEES COLLECTED
c' N t .% l PP/GCA d .C/G(- J2-
A.LIUATION G, Source GA ELECTRIC WATER SEWER
�{� of
a d O. Utilities Single
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 Building 2G
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 regula.ins construction or he Plumbing
performance of construction. I
DATE 9-/ 7 - 2/9 SIGNATURE ./s Ili
Mech.
SPECIAL APPROVALS SPECIAL CONDII' ONS:
DEPT. REQ'D. RECD. I
/ Plan Check
Env. Health
A? / e r (J
Off C '1? PfL SEPA O
F-
w
Planning — 2
Mobile Home cn
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. 0
SEPA Checklist (� 9 _,,l 7. _7 Q 41 z * �, O d F
DATE OFFICIAL U
APPROVED FOR ISSUANCE _