1979, 08-30 Permit: 79-3119 ResidencePLAN NUMBER —�
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
JO DDRESS
&'�a� LEGAL DESCRIPTION - SEE ATTACHED
LOT B CK SUB VI I N PARCEL NUMBER/S /� l 613
2. I NER �y�GI✓
CONTRACTOR
4' ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM TO
6.
Y7�`3 Size of
ZIP Yp�
PHONE Valuate
y
ZIP DWI
I yrt X NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% WORK WBLD. 1:1PLMB. ❑ MECH: ElM.H. El POOL
❑OTHER
Sacks in reet /
South a,`
3 4A 4�7
Oc a cy
_2
10 X 1 /a VOI
Split Entry {
No. Baths No. Floors
CERTIFICATE
of EXEMPTION
:ast �G' I (West
Zone Cla sification
S" a
Sprinklered
❑Yes f*<o ❑ Req'd.
Building Area in Sq. Ft.
931-1
rage ea St o age
� CIG
.evel I Rancher
No. Rooms I Rec. Room
ESCRIBE WORK (
FEES COLLECTED
8 ( � f
V LUATION 60
Source
of
GAS
FELECTRIC
R
SEW R
r9.
9. (��•
utilities
f; �'/
nW1AT
�V
/� n
Civ ��
Single $
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 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 ate or local law regulating construction or the
performance of construction. Plumbing
DATE e2 _ SIGNAT''- Mech,
SPECIAL APPROVALS SP CI CONDIT ONS:
DEPT. REQ'D. REC'D. ,�/ ffaclir
Plan Check
Env. Health la NV d
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
PEFj'-!IT NUPQBER
1.-3117 1
/
DATE 'Z -
02* *86.00
*86.00
*86006
A *0.00 0
25832
08-22-79
;F 6479.
Utilities O
TOTAL $ Q�
6.—
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
DATE FFICIAL
APPROVED FOR ISSUANCE 0 7 9
11. 8 6, 0 O a
_
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