1979, 09-10 Permit: 79-3731 Residence, Renewal of 79-3731rL—ANUMB R APPLICATION/ PERMIT
_�Q� SPOKANE COUNTY — BUILDING CODES DEPARTMENT
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1.
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DESIGNER
5. ADDRESS
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NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
LEGAL DESCRIPTION - SEE ATTACHED
SU/B}DIVISION PARCEL NUMBER/S �l,0%4611,6- /Yi
/✓/ / t7%G-�/%7 -
5-rA00 .L) `v
C PHONE 3-3 q-1— �d
q0>0,9
I p/� / ReA�uiied Set Backers in Feet �� r
�l % > 0!n
lNorth�ISou�th (East (West "
CHANGE OF USE FROM TO
6.
NE
PHONE
ZIP
TYPE KNEW 1:1 ALT. ElAD'N. El RPL. ❑ MVE.
7, OF ` ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
DESCRIBE WORK
8. Sj,v&4�
Size of Parcel
cone iassn icauon
/ --77
6G' � ! �✓� l.�� to
Type Const.
Occupancy
prinklered
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
L+
Oyes K No ❑ Req'd.
Valuatio
to give authority to violate or cancel the provisions of any other state or to Haw re ulating construction or the Plumbing
Building Area in t.
performance of construction.
j
DWL Area Basement Area
GWea
Storage
DEPT. REQ'D. RECD. Plan Check
Split /\y
Split
Level
Rancher
Planning
Mobile Home
No. B the
No. Floors
No.
Rec. Room
Co. Engineer
�Rooms
CERTIFICATE
Req'd.
I Recd.
Not Re,
of EXEMPTION
SEPA Checklist THIS B COMES A PERMIT.
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d
3 7'3,1 z 7 4, 0 0 Oa
n
FEES COLLECTED
PERMIT NUMBER
79- w73/
DATE sEe-7 /�j1q :71
02* *74.00
*74.00 N
*74,006
B *0.00
373,02
09-10-79
;? 6479,
VALUATION
9.
Source
of
utilities
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 grantin of a permit does not presume
to give authority to violate or cancel the provisions of any other state or to Haw re ulating construction or the Plumbing
performance of construction.
DATES I =f SIGNA'FtfR = Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
TOTA L $
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIS B COMES A PERMIT.
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d
3 7'3,1 z 7 4, 0 0 Oa
I DATE r-tv ! %OFFICIAL o-kyykldJ r n.."'[ld�[A(a, 1
APPROVED FOR ISSUANCE -