1979, 12-14 Permit 79-6445 ShedPLAN NUMBER.
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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
1. JOB ADDRESS
o 2 t2). 6
LOT BLOCK SUBD VISION ko
2.
OWNER
3 ��(/ 11X1—
N
AD R SSg 2_1) 12 ' I ,, - /
CONTRACTOR
4.
ADDRESS
PHONE
9,24-r71
?mac
PHONE
ZI P
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S Ir /I.3 ,^ 6�j f I
�1d2,!?zz +/i „r3i,I00 ICI
4i 0 lb- G, ^. Z-3, .z ' • ' J
Required Set Backs in Feet '1 F✓-�
North _lSouth 1 C9 1East ✓ west &''
Zone CI ssification
Size of Parcel
I W> I -O
Type Const.
Occupancy
DESIGNER
5' ADDRESS
PHONE
ZIP
Valuation
DWL Area I Basement Area
Sprinklered
Elves ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area Storage
6.
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
TYPE
7, OF
WORK
T NEW
LB BLD.
❑ ALT.
❑ PLMB.
❑ AD'N.
❑ MECH:
❑ RPL.
❑ M.H.
❑ MVE.
0 POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8. AVOC 7iC(1K 17—)
VALUATION Source GAS ELECTRIC SEWER
9
�L2�� of
UtICwr �r/T I '�
Utilities
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// 7 () SIGNATURE��
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
0//s/27
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
ivo 5 Id i, i. ►J° F71 N> •gZ10,
4A1 dv Jt%
DATE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
DATE
-..
PERMIT NUMBER
02*
* 17.00
* 17.00
6208g
10-17-79
g 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
10-22-79 644.5Z *17,002P
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