1979, 09-17 Permit: 79-4113 ResidencePLAN NUMBER
APPLICATION/ PERMIT
Z�Z
,A/VALUATION —
SPOKANE COUNTY — BAJILDING CODES DEPARTMENT
GAS
R.
EL CTC
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
SEWER
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JO ADDRESS
of
Utilities
LEGAL DESCRIPTION - SEE ATTACHED
1.
(/(f_
r
Single $
LOT
BLOCK SUB VISION
1-
W,7l
PARCEL NUMBER/S 33 5— / — ,) 03
7
2.
a . - .-/-o
w e- / r e
OWDR
PHOP4Es
3.
give authority to violate or cancel the provisions of any other state or local law regulating construction orperformance
ADDR SSZIP
Required Set acks in Feet ,
/
Q I'✓1v
nn
North South East West
SPECIAL APPROVALS
CONTRACTOR
PHONE
Size of Parcel , ba`
Zone Class cation
Plan Check
Env. Health
, '
4'
A RESS
SEPA
ZIP
Type Const.
Or pan
Sprinklere
Mobile Home
I
❑Yes [%Vo ❑ Req'd.
DESIGNER
PHONE
ValunOCA
C-
B6uilding Area in Sq. Ft.
Co. Engineer
Utilities
p
5.ADDRESS
TOTAL $_
ZIP
DW`L`Area
Basement AreaGar
ge rea
Storag ,
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
T t�
/
,1 411. 3 z
CHANGE OF USE FROM
TO
Split Entry
pli Level
Ranche
6.
No. Baths
No. Lloors
No. Rooms
Rec. Room
TYPE [� NEW ❑ ALT.
❑ AD -N. ❑ RPL. ❑ MVE.
7,
OF
❑ OTHER
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
BLD. 1:1PLMB.
E:1MECH: ❑ M.H. ❑POOL
WORK
of EXEMPTION
I
PERMIT NUMBER
-79- %1
DATE rEj�—L 1711974
0,2* *86.00
*86.00 N
*86.00
B *000
411-22
09-17-79
;? 6.479,
ESCRIBE WORK
+ {
FEES COLLECTED
8 , v {� Q S
,A/VALUATION —
Source
GAS
R.
EL CTC
WATER,
SEWER
f� ^,
Y,
9, J 1000
of
Utilities
!iV iy
r
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions inclu]ed
y„/
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governingBuilding
type of work will be complied with whether specified herein or not. The granting of a permit does not presto
give authority to violate or cancel the provisions of any other state or local law regulating construction orperformance
of construction.
��Q�Plumbing
DATESo�� 19SIGNATURE -L—"—Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
- -1 /a�
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
p
TOTAL $_
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
THIS BECOMES A PERMIT.
0 7_ 7 0/
/
,1 411. 3 z
DATE OFFICI a
APPROVED FOR ISS E
*86.00°
i-�lo —-SooS
N
1
I t 2. 1_ o 1
S ax, H &P---
1351