1979, 11-02 Permit: 79-7181 ResidencePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
ANPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
BLOCK�SUBDIV���o
2..3-
OWNER
3reirnr12/ LJ . 771/40r7'A411V
ADORES
/a?o T/J
CONTRACT
n7,9IS 1 7/f "71 ).s a, /
ADDRES
/1/7/G E doth'
/ .SIN 4.6.NT/o/.1
4.
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
9 ?&/c/
PARCEL NUMBER/S
A/17/6A/ 0,C
�?(s j °` 7/7,/s AvectL
P73/o/
Required Set Backs in Feet
North 'South ? 1
Size of Parcel
z*
Dy
/03 X /2.7
Type Const.
East 10 'West K • `0
Occupancy
Zone Cilas ification
C�1
Sprinklered
❑Yes IiNo ❑ Req'd.
DESIGNER
5.Coti TZ./Mad A / .OES/C/J
ADDRESS
PHONE
Valuation
4/a0
Building Area in Sq. Ft.
ZIP
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
NJW ❑ ALT. ❑ AD'N.
BLD. ❑ PLMB. ❑ MECH:
DWL Area kB red Garage Area
�"I�(ISplit Entry � e t41 li{ Level
Storage
Ran,r
❑ RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VAL
V � 04V111•;-( Source , `1 ' ' + " ELECT✓ C
VALUATION
Source AS
�� oO of
Utilities
9 ✓
I hereby certify that II 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 the
performance of construction.
SEWER
DATE to— '' 3 — 24 SIGNATUR
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
/6/025
ter\
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
'T ser
\/I T riom
DATE j)-2.-75
OFFICIAL
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMI1 '. IMBER
7q -7/8I
DATE
02* *31000
*31Q00
*310006
B *000
71808
11-02-79
g 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11-02'-79 71'8,12 *310,00x17
APPPfl1/Irn FM? IQQIIAMCF