1979, 10-02 Permit: 79-5116 AdditionPLAN NUMBER APPLICATION/ i)ERMIT
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 ADDRESS
LEGAL DESCRIPTION —SEE ATTACHED
1 LOT./PARCEL NUMBER/S j.7
B LO K I (
2 1�,9T.5
O NER� N q PHONE � ��
3. ; i G/ ON,0,-91) G17`h/ i4l%d%
AD RESS ZIP Required Set Backs in Feet
Q7
r-
North Zy South ,�°i
East West '
CO 'TRACTOR
PHONE
Size of Parcel
Zone Classificalion pI�y
4. AD RESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5. ADDRESS
ZIP
DWL Area/
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split
Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec.-Room
TYPE ❑ NEW ❑ ALT. ❑ AD -N. ❑ RPL. ❑ MVE.
], OF ❑ OTHER
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
El BLD. ElPLMB. ElMECH: ❑ M.H. 11 POOL
WORK
of EXEMPTION
x
DESCRIBE WORK
8
FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
of
9,� 'CIU' utilities
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 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 state or local law regulating construction orthe
performance of/ construcc+tion.n / y
Plumbing
DATE SIGNATURE`S " i
Mech.
SPECIAL APPROVALS
DEPT. REQ'D- REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
Plan Check
il/yl-0 f- fk�L SEPA
Mobile Home
DATE
`✓ PERMIT NUMBER
DATE I 7q
02* *110.50
* 1 1 X1,5 0 N
*11(1501
E *0.00 0
490,7
09-28-79
-4 6,479.
0 j GC'LL���.�•�f�y v Other (Specify)
TOTAL $WHEN MACHINE MACHINE VALIDATED IN THIS SPACE,
_ OFFICIAL
APPROVED FOR ISSUANCE
THIS BECOMES A PERMIT.
14-02-7-9 511,62 *110,50°
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