1980, 08-19 Permit 79-696 25 KW RaywallPLAN 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.
LOT
2.
BLOCK
SUBDIVISION
3
4.
OWNER e.
I Il
ADDRESS
grata,cl`C
CONTRACTOR
ADDRESS
) c - _ rl k4 C` r
S ck. 7 C\
DESIGNER
5. ADDRESS
`c u i r-.) Ct C. -C"—
PHONE ))
ZIP
PHONE
C'-
PHONE
ZIP
Z'�a
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
Required Set Backs in Feet
North 'South
Size of Parcel
Type Const.
Valuation
Occupancy
East
W est
Zone Classification
Sprinklered
❑Yes ❑No 0 Req'd.
Building Area in Sq. Ft.
DWL Area I Basement Area Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
TO
❑ AD'N. RPL.
MECH: ❑ M.H.
❑ MVE.
0 POOL
0 OTHER
Split Entry
No. Baths
Split Level
No. Floors
No. Rooms
Rancher
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
8.
VALUATION
9.
)•s iZCA L,,,\ CA l (
J GAS
Source
of
Utilities
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 SIGNATURE
DEPT-
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SPECIAL CONDITIONS:
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ • 16
DATE —7`1 — `7
04* *7.00
*7.00 v~i
*7.006p U
A *000
695m
07-19-79
6,479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist
DATE7I• OFFICI
APPROVE FOR ISSUANCE
07-19-79
69.6Z *7,00 _