1979, 10-17 Permit 79-6160 Residence, GaragePLAN NUMBER
2-3-fi
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
LOT
BLOCK
SUBDIVISION
O)1NER () •
3 ./f,o-ij/r ,.Jt.,i)C.L
ADDRESS
CONTRACTOR
4. t464lfr6Ge —
ADDRESS
/t
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
TO
TYPE ,NEW 0 ALT. 0 AD N. ❑ RPL.
7. OF
WORK BLO. 0 PLMB. ElMECH: ❑ M.H.
❑ MVE.
❑ OTHER
❑ POOL
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER'S
A/. /' J 3,GK/ `i �NT4 1,'+=1-`'!{ PA1ilY
75 %`/ C?dZi
Required Set Backs in Feet
North: i-� South,+fi East ./ k West L
Zone Classification
Sprinklered
❑Yes ❑No El Req'd.
Size of Parcel
Type Const. Occupancy
V-N 12.- 3
Valuation
DWL Area
Basement Area
Building Area in Sq. Ft.
Garage Area
Storage
Split Entry
Split Level
No. Baths
1
CERTIFICATE
of EXEMPTION
No. Floors No. Rooms
Req'd.
Rancher
Rec. Room
Rec'd.
Not Req'd.
8.
DESCRIBE WORK (1 J
VALUATION () Source
9.�<jc'M(9 Utilities
GAS
/G(/i(_Q,G
ELECTRIC
WATER
SEWER
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() --// - 76/ SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
pis ok. 16-16..7/
DATE+/'-//-7'OFFICIAL., l k-12'1)
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PERMIT NUMBER
79-6 /C'd
DATE /C3 - / 7-- 7 9
02* *29,2.00
*29200 t
*292006
E *000
615.9g
1 0-1 7:-79
a 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOM A PERMIT.
10-,117'-7:9 6'16.0z *292,0,02p'
7 3.
v AMA
9o•ig'
PRo Posao
•.
P9
PERMIT NO.
Spokane County
Planning Department
Short Plat
Exemption Certificate
1. WAS THIS PARCEL SEGREGATED BEFORE MARCH 13, 1978, OR WAS APPLICATION
TO SEGREGATE MADE BEFORE MARCH 13, 1978 ?
(exempt under section 3.3B5 of Short Plat Ordinance)
2. IS THIS PARCEL 10 ACRES IN SIZE OR LARGER ?
(exempt under section 3.3E of Short Plat Ordinance)
3. WILL THIS PARCEL BE USED FOR A PUBLIC UTILITY FACILITY ?
(exempt under section 3.3B4 of Short Plat Ordinance)
4. IS THIS SEGREGATION BEING ACCOMPLISHED TO EFFECT A MINOR BOUNDARY
OR PROPERTY LINE ADJUSTMENT, BUT NOT CREATING ANY NEW LOTS OR
CAUSING OTHER LOTS TO FALL BELOW MINIMUM ZONING STANDARDS FOR SIZE
SHAPE OR FRONTAGE. OR AFFECTING ROAD ACCESS TO ANY OTHER LOTS ?
(exempt under section 3.3H of Short Plat Ordinance)
5. IS THIS PARCEL ZONED RESIDENTIAL OFFICE. LOCAL BUSINESS, COMMERCIAL,
FREEWAY COMMERCIAL, INDUSTRIAL OR MANUFACTURING ?
(exempt under section 3.364 of Short Plat Ordinance)
APPROVED BY:
YES
YES
NO
4
YES NO
YES
DATE:Jo /11 /74
I hereby certify the answers I have offered in connection with obtaining,
this exemption are true
APPLICANT'S SIGNATURE: % a%: //,/ DATE:J /1/ /%f
I (ftINL Whit,
N /21 IRiFtl$SON STN[E1 SPOKANt WA>MLMOION IQ26P
Pf(.NF it.?:'