1979, 09-19 Permit: 79-4276 ResidencePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
8.
VALUATION` Source AS ELECTRIC WATER SEWER
of
9 d.„F;,f. J/� Utilities Single $
I hereby certify that I have read and examined this application and have read the "NOTICE” provisions included vI>
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 Plumbing
performance of construction.
� rs t
DATE ! " i ` SIGNATURES -�— Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health i
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
V
i
DATE OFFICIA� t_
APPROVED FOR I
JACE
SEPA
Mobile Home
Other (Specify)
TOTAL $ I,?/
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
09-19-79
PERMIT NUMBER
DATE 7%
02* *301.00
*301.00 N
*301.00
E *0,00 n
427.52
09-19-79
;@ 6479.
IN THIS SPACE,
4 '7,6 *301.0.0�r
w
WE
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
BL CKSUBDIVISION
PARCEL NUMBER, 7�—
t"':T
t
OWNER
PHONE
ZIP
Required Set Backs in Feet
.s
ADDRESS
IAC! '—.., � i
,/-t
-
CO,,
r
North South 3 L?
i
East West -ill
s
CONTRA/CTOR l
d
PHONE
Size of Parcel
,,
Zone ClassificationISered
4.
ZIP
Type Const. O p' ancy kl❑
pYes
ADDRESS
❑o Req'd.
ini
DESIGNER
PHONE
Vallo/n, D�
Building Area in Sq. Ft.
1X
5.
ZIP
DWL Area I
Basement Area
Garage Are
Storage
ADDRESS
I
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
s.
No. Baths No. Floors No. Rooms Rec.
� JRoom
TYPE X NEW ❑ ALT.
ElElEl
AD'N. RPL.
MVE.
1
U/0
7.OF
BLD. ❑ PLM B.
ElMECH: [IM.H.
OTHER
❑POOL
CERTIFICATE
Req'd.
Recd. Not Req'd.
WORK
of EXEMPTION
8.
VALUATION` Source AS ELECTRIC WATER SEWER
of
9 d.„F;,f. J/� Utilities Single $
I hereby certify that I have read and examined this application and have read the "NOTICE” provisions included vI>
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 Plumbing
performance of construction.
� rs t
DATE ! " i ` SIGNATURES -�— Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health i
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
V
i
DATE OFFICIA� t_
APPROVED FOR I
JACE
SEPA
Mobile Home
Other (Specify)
TOTAL $ I,?/
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
09-19-79
PERMIT NUMBER
DATE 7%
02* *301.00
*301.00 N
*301.00
E *0,00 n
427.52
09-19-79
;@ 6479.
IN THIS SPACE,
4 '7,6 *301.0.0�r
w
WE
as
-
w Rr
VAIVC
.rte f
301
30.�a
a o�
700 ---IV