1979, 10-05 Permit: 79-5381 Damper PLAN NUMBER _ APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT g 79-x'38/
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /4-"5--79
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
04 * * 7,00
JOB ADDRESS 7-6, LEGAL DESCRIPTION — SEE ATTACHED
1. f- /v 7/ 3 v * 7.00 tz
LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 7,0 0 U
2.
OWNER � PHONE E * O,0 0 8U
3. Y ^4 c k CCeicy_c/';-v _RA
ADDRESSy- ZIP Required Set Backs in Feet 5 3 8 0$
, /0'2/ 3 4-A4) '��* 7?A L/e North (South East (West 1 0 0 5-'r 9
CONTRACTOR PHONE Size of Parcel Zone Classification
A7 ....47u.w/t-7, fie.„,..Ji`i� L - 5'ot 8--?,0, 2 6,4 7 9.
ADDRESS G �j4'�e ZIPIPType Const. Occupancy Sprinklered
/a 7/V /sL--Lv.
' a, c/ .5p/�' " 6' _ ( 9 it, Eyes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS ZIP DWL Area Basement Area Garage Area Storage o
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room A
TYPE 0 NEW ❑ ALT. ❑ AD'N. 0 RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. CIPLMB. ElMECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION i
DESCRIBE WORK
_ FEES COLLECTED
8.
/4,„,..• 7-4: / s/�tic- /-mac C / &e,'YIJ,,c-4 ri1 GPS /amu X-v-?e `fi'
VALUATION Source GAS ELECTRIC WATER SEWER
of
9. 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
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. / Plumbing
DATE /0 `jam- 77 SIGNATURE / y� "j .../--1-- - ',,,,' „' '4L
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: '/Fit r ��_'J y G4!
DEPT. REQ'D. RECD. Plan Plan Check
6 54i/ -. / &l(.y�C',1_
Env. Health
SEPA
Planning U
4J
4
Mobile Home cn
-
Fire Marshall
Co. Engineer Other (Specify)
Utilities TOTAL $ 9'G''C✓
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE/6)37ppOFFICIAI 12`�L/ O GAQ/ 10',O 5"-T9
1 8.1
, * 7.0
0 O
APPROVED FOR ISSUANCE _