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1979, 10-24 Permit G79-6593 Space HtrPLAN 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 LOT BLOCK ADDRESS 1 "ice ( e COIaITRACTOR 4.�GI�t yDRESS /a.�r2rP DESIGNER 5. ADDRESS SUBDIVISION CHANGE OF USE FROM 6. TYPE 7, OF WORK ❑ NEW ❑ BLD. ❑ ALT. ❑ PLMB. PHONE 9 a39 '2 ZI P PHONE ZIP PHONE ZIP TO ❑ AD'N. MECH: ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER LEGAL DESCRIPTION - SEE ATTACHED PARCEL NUMBER/S Required Set Backs in Feet North !South [East 'West Size of Parcel Zone Classification Type Const. Occupancy Sprinklered Eyes ❑No E Req'd. Valuation Building Area in Sq. Ft. DWL Area I Basement Area Garage Area Storage Split Entry Split Level Rancher No. Baths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. DESC 8. VALUATION 9. I E WORK -of.A re : `— Source of Utilities GAS 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 cal law regulating construction or the performance of construction. DATE / J7� SIGNATURE DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: t DAT6(e9'23J79OFF ICIAIe7 l;af 'k ADDDO\/Ffl COO ICCIIANrE Req'd Not Req'd. FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ PERMIT NUMBER DATE,U 04* *12.00 * 12,00 * 1 2,006 Ir *0.00 8 659.22 10-24-79 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. InMODCPT(1D 10-24--'7'9 6'59.3z -*12,002r!