1979, 09-17 Permit: 79-4115 ResidencePLAN NUMBER
r0-222
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 9960 / (509) 456-3675
DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 36 A A
it-.1702-7.7; am v&
2.
BLOCK
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION km r r AY:A, /OW
3. Ow/j uC€ f/(`/d A /
ARES$ ri i Ca %'1pb J
CONTRACTOR.
4SA
. M�
ADDRESS
PHONE
9.2 —,_57005
ZIPgQ, V 2
PARCEL NUMBER/S 33
5 1/40 q D° T
Required Set Backs in Feet
North 73 iSouth
PHONE
ZIP
3 3
Occ pant
t area
/ QlNF
Size of. Parcel
/3''2' ji/ 75
Type Const.
V r\)
DESIGNER
5. ADDRESS
PHONE
ZIP
CHANGE OF USE FROM
6.
TO
East
(�/
Zo a Classification
(West U
?5.
Sprinklere8
❑Yes XNo ❑ Req'd.
Valu ion Building Are n S Ft.
WL Area BasemeGarag A rre
l oZ 4/Z)
Split Entry Split Level
—
Storage
Rancher
TYPE
7. OF
WORK
I`� NEW
BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
D RPL.
❑ M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
61.9
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
No Req' .
D SCRIBE WORK
s. w s. rA M. Q
VALUATION
9. 58 )&)
Q)
Source
of
Utilities
GAS
E ECTRIC
ItalAd EX/
W TER
SEW R
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 provisions of laws and ordinances governing this
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 constructiont��or the
performance of construction.
DATE C L\ N,.l1 SIGNATURE C V" '---` I�r-�-�`��
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health c �
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
PIANS For
Z60,en/f,c a /
2 St/uctfre_,j Arm
DATE OFFICIAL
APPROVED FOR ISSUACE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
Sst Dj
TOTAL $ .c �o/ 4
PER(`,:IF NUNVER
7c7 et/l.
SEe-r r7pne/
02* *8600
*8600 t
*86.00
B *000
4-11.42
09-17-79
2 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-17-79 411,5! *86,00a
14;
o t.s 014-c->^h++as t w.0, aclo-Ll
• °l.....te
-Soon
r,
N
4-8_. 2a•
21.
/
—log_
a
r
ft
•
- J
°ty.sg
A-L. 4 .,(F.
Lot R
M;b;\o
3S5`l\ - `tco�