1979, 10-02 Permit: 79-5103 PatioPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
No. Baths No. Floors No. Rooms Rec. Room
TYPE )N NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. / 1
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M. H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK / FEES COLLECTED
8. ` 2 0
VALUATION Source GAS ELECTRIC WATER SJR
of
��� Utilities ngle $
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 rdI ances gouildingtype of work will be complied with whether specified herein or not. T a�i ting of per it does nto give authority to violate or cancel the provisions of any othe r I cal' law r la ' g constr�lcumbinperformanceeoff construction. g
DATE / �/SIGNATURE 4 t.;/iech.
DEPT.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL APPROVALS
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
RECD
LEGAL DESCRIPTION- SEE ATTACHED
LOT
BLOCK
�
SUBDIVISION
PARCEL N MBER/S
>tfjf2 - lgf7 Co
2.6
4E� AR1�
i�Db
OWNERqICI
'PE/"
6:50.5
3.
/ji /"CJ�AJ
f��E
ADDRES�S7
qt.r;�
ZIP�i
Required Set Backs in Feet
v 112 Z3
^�
9
e�
CONTRACTOR
PHONE
North South
Size of Pavel I
East West
Zone Classification
4. -51111415-
/ l ��
! l�
ADDRESS
ZIP
Type Const.
Occupancy
/�sY�
rpSp�r�inklered
❑Yes DKNo ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
-
-
No. Baths No. Floors No. Rooms Rec. Room
TYPE )N NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. / 1
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M. H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK / FEES COLLECTED
8. ` 2 0
VALUATION Source GAS ELECTRIC WATER SJR
of
��� Utilities ngle $
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 rdI ances gouildingtype of work will be complied with whether specified herein or not. T a�i ting of per it does nto give authority to violate or cancel the provisions of any othe r I cal' law r la ' g constr�lcumbinperformanceeoff construction. g
DATE / �/SIGNATURE 4 t.;/iech.
DEPT.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL APPROVALS
REQ'D.
RECD
SPECIA CfO�bITIONS:
Np �?Q
DATE%Z3-/%'OFFICIAL�j�"at
APPROVED FOR ISSUANCE
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ��• ��
PERMIT NUMBER
DATE %/''/
02* *2200
*2200
*22006)
E *000 00
51Q29
10-02-79
;9 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS B�COMES A PERMIT.
* 2 2. D 1 a �-
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