1979, 11-29 Permit: 79-8515 InsertPLAN 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 11,316- LEGAL DESCRIPTION - SEE ATTACHED
LOT -1B PARCEL NUMBER/S
2.
9YVN ER
3.
ADD R S
,ONTRACTO�t
4.ADDRESS
e, 9-: /:111- -724
DESIGNER
5. ADDRESS
CHANGE OF USE FROM —�TO
6. --- -
PHONE
ZIP
Required Set Backs in Feet
//
C -! „�..� SP
North South East West
PHONE
Size of Parcel
Zone Classification
.t
ZIP
Type Const.
Occupancy
Sprinklered
-7 V.2-0
❑Yes ❑No ❑ Req'd.
PHONE
lValuation
I Building Area in Sq. Ft.
ZIP DWL Area I Basement Area Garage Area Storage
Split Entry Split Level Rancher
No. Baths No. Floors No. Rooms Rec. Room
I rrt ❑ NEW ❑ ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
7. OF ❑OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M. H. ❑ POOL CERTIFICATE Req'd. Recd. Not Rec
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
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 pro v' ' aws and ordinances governing this Building
type of work will be complied with whether specified herein or n.o"t. The gran ing of a permit does not presume
to give authority to violate or cancel the provisions of any other state o loc law regyllati g constru tion or the
performance of construction. ! dumbing
f�
d e-
PERMIT NUMBER
f ,5—/
DATE l/ ,_Z)-2`9
04* *7.00
*7.00
*7.006
E *0.00 0
851.42
11-29-79
-9 6,479.
DATE SIGNAT E Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
/ THI$B COM WHEN MACHINE VALIDATED IN THIS SPACE
SEPA Checklist ,
-�� o - 7C � 7 $,A PERMIT.
�_. 1 �
DATE OFFICIALA&AL ^
3 51,55
APPROVED FOR ISSUANCE
*7.0,0°Pj.