1979, 09-27 Permit: 79-4815 ResidencePLAN NUMBER ---� APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
ALUATION Source GAS ELECTRIC WATER Sjnudeid
9 d �s of
Utilities
I hereby certify that I have read and examined this application and have read the "NOTICE" provisio
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances gotype of work will be complied with whether specified herein or not. The granting of a permit does nto give authority to violate or cancel the provisions of any other state local law regulating construcperformance of construction.DATE 1 7`% SIGNAT��
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Env. Health q /-)
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE / OFFICIAL_
APPROVED FOR ISS N E
Single $
Building cJ b tt
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
FE -Ti MIT NUMBER
DATE q—ZZj-:Z j
02* *251,50
*251.50
tn-
*
B *0.00 C
4 81.4 11
09-27-79
;P 6479,
TOTAL $�F
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 9- 2 7- T9 4 8 1.5 25* 2' 51 '51
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
LOT I BLO K ISUBDLVIbIL)N
_
PARCEL NUMBER/S
2.
��
t `PHONE
1--e) 7-
WNER
3.
2�'Ve
ADDRESSe,--4
ZIP
Required Set Backs in Feet
1 �� { r
c� Q
!
North / ( South ? East .�:. WestL
C NTRACT03R
PHONE
of Pa/cel Zo a Classification
4.
zd'u 1 -Size
7�:� /'sem �� 1
ApDRESS
jl'y
ZIP
Type Const. Occupancy prinklered
i"
❑Yes ❑ Req'd.
DESIGNER
PHONE
Valuat' n Building A ea in Sq. Ft.
5.
�� .tom.
ADDRESS
ZIP
DWL Area/�Barea Garage Area Storage
CHANGE OF USE FROM TO
Split ntry Split Level Rancher
6.
TYPE (� NEW El NEW ❑ AD'N.
1:1 RPL. EJMVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7,
OF
WORK BLD. ❑ PLMB. ❑ MECH;
11OTHER
1:1M.H. ❑ POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
of EXEMP TION
8.
DESCRIBE WORiK
Q�
FEES COLLECTED
ALUATION Source GAS ELECTRIC WATER Sjnudeid
9 d �s of
Utilities
I hereby certify that I have read and examined this application and have read the "NOTICE" provisio
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances gotype of work will be complied with whether specified herein or not. The granting of a permit does nto give authority to violate or cancel the provisions of any other state local law regulating construcperformance of construction.DATE 1 7`% SIGNAT��
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D.
Env. Health q /-)
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
DATE / OFFICIAL_
APPROVED FOR ISS N E
Single $
Building cJ b tt
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
FE -Ti MIT NUMBER
DATE q—ZZj-:Z j
02* *251,50
*251.50
tn-
*
B *0.00 C
4 81.4 11
09-27-79
;P 6479,
TOTAL $�F
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0 9- 2 7- T9 4 8 1.5 25* 2' 51 '51
GjRCIV"y TNG
w
�BNG