1979, 09-26 Permit: 79-4763 ResidencePLAN NUIM7 APPLICATION/ PERMIT
"' �2 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 LEGAL DESCRIPTION — SEE ATTACHED
`SUBDIVISION
LOT
BLOCK
PARCEL NUMBER/S
2.
!0
3����
%` �'T —Com." /�6
J
� C.�-3
OWN R
�� ��
P1 -ION
Z i5!
3.�
: ;� Im
AD RESS _
'
1-2- ---2,
��
S dC.�
ZIP
`,�
7 ���
Set Backs in Feet
North -.k-' South r
East West
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
/`
C . t
C5
(,
1Sprinklered
4•
ADDR SS 2 ,v-�, 1 �
�1 `1> J C1 �T~
`
h
` �4'
ZIP
� � 1
Type t.
Oc _p y
`j I
Dyes No ❑ Req'd.
.___'�
DESIGNE
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area Basement Area
Garage Area
Storage
7�9
CHANGE OF USE FROM
TO
Split Entry
Split
Level
Rancher
6.
No Baths No
Floors
No. Rooms
Rec. Room
TYPE )54QEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF El OTHER
BLD. ❑ PLM B. ❑ MECH: L1M.H. El CERTIFICATE Req'd. Recd. Not Req'd
WORK of EXEMPTION
DESCRIBE WORK FEES COLLECTED
8.
VALUATION Sourc GAS ELECTRIC WATER SEWER
9, � r Utilities �7JG i��}� IGL— ►til OiI'C�M �. Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included �p
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Buildinga�+-�
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 oc aw regulating construction or the
Plumbing
performance of construction. %,
DATE ` — ZL) 7 SIGNAT Mech.
SPECIAL APPROVALS
DEPT. REQ'D. REC'D.
Env. Health
Planning Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
`V,'; ,
DATE OFFICIAL-"__'
APPROVED FOR ISSUAP C
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
DATE
02* *26500
*26500 L
*26500
E *O.c0
476,22
09-26-79
2 6,479,
TOTAL $g.Sg.`
WHEN MACHINE VALIDATED IN THI
THIS BECOMES A PERMIT.
9 -2 E'-7 9
*`265,00,"
7-7
5
DELTA COMPANY
11123 L 30th AVE
SPHAKE, WA 992319
928-1w14