1979, 09-20 Permit App: 79-4346 Cover and Addition16, AN NUMBER
L.
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
2.
3.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
. 'Y � ON
LO B OCK S BDIVIS ON
O,NER/ /
t Ate,2.
ANDRE
S
LEGAL DESCRIPTION — SEE ATTACHED
PHONE
7
Co t`jTRACTOR
4.
ADDRESS
DESIGNER+
5
ADDRESS
ZIP
9941/,;
PHONE
PARCEL NUMBER/S ��,,s-.j — ci.-,0�
Joh, 7 x C, SIJ. 445- Lort 041-c-
11 C OR13iN APP TD . kE,F,t/a4C%g5
Required Set Backs in Feet
North
Size of Parcel
South
East West
Z Classification
ZIP
Type Const.
Occupancy
PHONE
Sprinklered
:Yes ❑No ❑ Req'd.
Valuation
Building Area in Sq. Ft.
CHANGE OF USE FROM
6.
ZIP
DWL Area
T
774)
Split Entry
Basement Area
Garage Area Storage
Split Level
Ranche
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
ESCRIBE WORK
L{,
VALUATION
9.
026—) 6/-0-0 °=`2
❑ ALT.
❑ PLMB.
❑ AD N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.LAOTHER
❑POOL n`
No. Baths
No. Floors
/
No. Rooms
3
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Source
of
Utilities
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of construction.
DATE
GAS
ELECT'IC WATER
SEWER
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or local law regulating construction or the
'7
SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D.
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE? 7(OFFICIA
APPROVED FOR ISSUANCE
Rec'd. Not Req'd.
FEES COLLECTED
Single $
Building /
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ ! 70
6
DATE
PERMIT NUMBER
79 -4346
02* *17000
* 17000 N
* 1 70.006'
E *0.00
431.51
09-20-79
I 6,479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09ii-,,20'-N 43462*1'70.002�
INSPECTOR