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!