1979, 08-07 Permit: 79-1636 Garage �arLAN NUMBER ' • APPLICATION/PERMIT PERMIT NUMBER I
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 79-1636,
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (5091 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 2* * 1 5 0 0
1 JOB ADDRESS 1 I 23 /�`.'.. LEGAL DESCRIPTION — SEE ATTACHED * 1 5.O O N
q A-V. , *
LO B LOCF SUBDIVISION PARCEL NUMBER/S
2. A - �-� rjc,- -2.-2-0I A z *Q00 o
3. OWNER ��i�� Pl-iA...._ 7, 1 533/
AD6�SS �� ZIP/�i,v(�/ F✓'� Required Set Backs in Feet I 0 8—O 37 7 9
W� North lSouth� East rs IWest 4 7 9
CONTRACTOR PHONE Size of Parcel Zone Classificatio
4. ° `� kiwi, ),
ADDRESS ZIP Type Const. Occupancy Spri klered
❑Yes ENo ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE
W ❑ ALT. 2/AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK YYYddd BLD. ❑ PLMB. ❑ MECH: 0 M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DE CRIB WO�2}}��
8 �[ I— 11\11.1)
i .,j/ r A gc f�X 32 FEES COLLECTED
V L ATION [/Y/ 7 S urrc(ee GAS E ECT IC ATER SEWER
I /I of
9.
000 Utilities � ij. I�
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 a • inances governing this Building 15/ ‘1C7
type of work will be complied with whether specified herein or not. The grantint •f a pe it does not presume
to give authority to violate or cancel the provisions of any other st. or o..l .w regula ng construction or the
performance of consfjuction. Plumbing
DATE SIGNA _4h Xalik / Mech.
SPECIAL APPROVALS SPECIAL Co '% TIONS
DEPT. REQ'D. REC'D. Plan Check
Env.Health M t\I'I V -rD ' 1Je.7191‘/
c\Ir...VQJ/J� V3/7.9 SEPA P
Planning //
i/ 0
Mobile Home �'
Fire Marshall •
Co. Engineer Other(Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist �f THIS�F�CO OES A PERMIT.
DATE
3// OFFICIAL �tff ( IN
7 1 3, 6 z 15, 0.0 °
APPROVED FOR ISSUANCE —
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