1979, 09-20 Permit: 79-4429 InspectPLAN NUMBER APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS 11ARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION —SEE ATTACHED
LOT
BLOCK
2.
I
ISL
OWNER
I Occupancy
3. /S
CERTIFICATE
ADDRESS
Building Area in Sq. Ft.
13 0
COJRACTOR
Basement Area
Garage Area
Storage
4'
Split Entry
A11DRESS
Rancher
5. "[
ADDRESS
CHANGE OF USE FROM ITO
6.
f
PHONE
ZIP
PHONE
ZIP
WJ
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL.
Required Set Backs in Feet
North South East West
Size of Parcel
Zone Classification
Type Const.
I Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
CERTIFICATE
Valuation
Building Area in Sq. Ft.
,y/
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
DESCRIBE WORK
'
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE. //
7, OF
ElBLD. ElPLMB. ElMECH: ElM.H.
Pd DTHER
❑ POOL !!
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
'
FEES COLLECTED
8
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
9,
Utiliofties
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 J '-
SIGNATUR� .
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.�%
Env. Health
/// T ,
V /' d -c ' 4 ( ./� S 2e c f, o 1,l
Plan Check
Planning
/
."G Cel r r '�^�j C o� L, /W- US Iil t I e 7K QJ%v�s
SEPA
Fire Marshall
q U �/
�g4�c ��
Mobile Home
S=�,7//'
voy C; L y]� e r .
.SP ?� _
'�C-/ /dam
0
/V . ?�L
Co. Engineer
Other (Specify)
Utilities
TOTAL $ k
Zone Clearance
WHEN MACHINE VALIDAI
SEPA Checklist
e: ///JJ
THIS BECOMES A PERMIT.
g . �p n
O O — 9
�y
DATEf '' L" i OFFICIAI.���L , �l /�i;✓4Lc��
.�2
/
APPROVED FOR ISSUANCE
PERMIT NUMBER
ill
DATE
02* *a00
*8.00 15
*a000l-I
E *0.00
4428
09-20-79
2 6479,
i SPACE,
9 1 * 8.00