1979, 08-22 Permit: M79-2607 ACPLAN 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
JOB ADDRESS 1,4111
LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNER
'2 i.^41�.•NuJ� W Ifs-�,v ��,J'" /_J
v ADDRES
CONTRAC R
a. ems'
:ADD SS
DESIGNER
5' ADDRESS
CHANG(= OF USE FROM TO
6.
TYPE �L NEW ❑ ALT.
7, OF
BLD. ❑ PLMB
WORK ❑
DESCRIBE WORK
ZIP �O
Requireo Set Backs in f-eet
North South East West
P/HANE
7U V 1170
Size of Parcel
Zone Classification
ZI n
�v
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
❑ AWN. ❑ RPL. ❑ MVE.
�.J ❑ OTHER
L]E MECH: ElM.H. El POOL CERTIFICATE Req'd. Recd. Not Rec
of EXEMPTION
sl. n n j FEES COLLECTED
DATE
PERMIT NUMBER
ti
04* *7.00
*7.00 'Cn-
*7.006
A *000 00
26a62
08-22-79
;P 61479.
VIAL -UA I IUN
Source
GAS
ELE. CTiRIC
WATER
SEWER
9.
of
Utilities
\/Y_/
Single $
1 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 SIGNATURE—
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities0
TOTAL $7
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
. C
�JqOFFICIAt,��
THIS BECOMES A PERMIT.
0
G'�---R
��77 U.7 O d F-
DATE
.7.