1979, 10-29 Permit 79-6897 TrailerPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. LjiC5z pCvt CT.P.CLE
LOT BLOCK SUBDIVISION
2 317 Co L.o, Be e eti Ta l e e_PA M.
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3. eve L1Y\ fEnkE
ADDRESS
CONTRACTO ii ,� u
�OICjL Ln tIZi �!f
4. ADDRESS
,J7LiI�
DESIGNER
5' ADDRESS
6.
SPACE 53
t-s
CHANGE OF USE FROM
TYPE
7. OF
WORK
NEW
❑ BLD.
❑ ALT.
❑ PLMB.
PHONE
c72i701O
ZIP
PHONE
Z
ZIP
17az
PHONE
ZIP
TO
❑ AD'N.
❑ MECH:
❑ RPL.
ki M.H.
❑ MVE.
❑ POOL
❑ OTHER
PARCEL NUMBER/S
S 3 - Z53r1
Required Set Backs in Feet
North South )
Size of Parcel
Type Const.
Valuation
DWL Area
OccupancY
Basement Area
East —3 °
We
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Split Entry
Split Level
Rancher
DESCRIBE WORK
8. ;A5i--011.
VALUATION Source
of
9. 101000 Utilities
No. Baths
No. Floors
CERTIFICATE
of EXEMPTION
SEWER
No. Rooms
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
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 or the
performance of construction.
DATE /L`--1 `` h - 7,90
SIGNA
Req'd.
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPE
CONDITIONS:
iVi AIL c.X)1v -ro cc) Nr+KAc
Wt+EA) C Ae66
DAT/_/ OFFI
APPR!""i FOR ISSUANCE
Rec. Room
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home OCG
Other (Specify)
TOTAL $
DATE
PERMIT NUMBER 7
,9
07* *5000
*50,00
*50,006
B *0.00 8
689.62
10-29-79
2 6[t79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10 -2 91 709
689,7z *;50.00°H
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