1979, 09-19 Permit: 79-4278 ResidencePLAN NUMBER
JOB ADDRESS
i. ✓ 1
LOT I BL CI
WNER r
3.
ADDRESS
7
CO TRACTOR
-=
4. AD RESS /
DESIGNER
5. ADDRESS
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
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISIO PARCEL NUMBER/S
L e,�
PHONE -g M / 4,j
ZIP �1 Required Set Backs in Feet.,�, 1
G �q�C/� � North,10 South 1 [ East 71 WestZ5�
PHONE Sizeof Parcel Zone Classification
lDU a L 41.
ZIP Type. onst. Occypy Sprinklered
/ ❑Yes o ❑ Req'd
CHANGE OF USE FROM
6.
PHONE
ZIP
TYPE' NEW E]ALT. ElAD'N. ❑ RPL. ElMVE.
7 OF WORK N(BLD. ❑ PLMB. E)MECH: ❑ M.H. El POOL
❑ OTHER
Valu ion
Building Area inFt.
Sq.
DWL
Basement Area
Garage Are Storage
1Area
�� s
-� .
ao
Split Entry
Split
Level Rancher
No. Baths
No. FI ors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
Recd.
Not R q'd.
of EXEMPTION
FEES COLLECTED
8.
VALUATION Source f GAS ELECTRIC WATER SEWER
of
9, `5 I)Q� Utilities 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 construc ' n or the
performance of construction. Plumbing
DATE"�� % ✓ SIGNATURE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities
Zone Clearance
-IPA Checklist /G
/ DATE OFFICIA
n
APPROVED FOR IS
�% PERMIT NUMBER
DATE
02* *301.00
*301.00
*301.0061
E *0,00
427.7-9
09-19-79
2 6.479,
TOTA L $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-19-79 42782 *30 100 °�
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