1979, 11-27 Permit 79-8398 Trailerak•
• l
OWNER
3. D c c J�
A DRESS
4.
CONTRACTOR
ADDRESS
DESIGNER
5. ADDRES
6.
PLAN NUMBER
APPLICATI9N/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
PERMIT NUMBER
7 76
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
�`. / 7 0 3 C2
LOT BLOCK SUBDIVISI_._�
%?1' ice c1 �C? i i
I aCt.d Lc' cL
y�
r 47,
tkariif cry
CHANGE OF USE FROM
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
TO
❑ AD'N.
❑ MECH;
❑ RPL.
❑ M.H,
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
PHONE /•,.,:1, J • /a::--t\ /
` 4/733a-L- PEA /A R5s- ,t'
Z p i Required Set Backs in Feet
ya 3 7 North /v4 I ' South/. East . .4 i (west ..n"
PHONE Size of Parcel 11 e Classification
Nov 1 c roc / `tu r K.
Type Const. Occupancy 1 Sprinklered
ZIP
PHONE
ZIP
❑ MVE.
❑ POOL
❑ OTHER
Valuation
DWL Area
Split Entry
No. Baths
CERTIFICATE
of EXEMPTION
❑Yes DNo El Req'd.
No. Rooms
Req'd.
Rec'd.
Not Req'd.
DESCRIBE ORK
8.
ffiti
7VAL •TION
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 constr ction.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
DATE
SIGNATURE
4
4
SPECIAL APPROVALS
DEPT. REQ'D-
REC'D.
Env. Health
.<7o /7`2
Planning
<-;4-mr
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
due-61-78'
DATE 4�
-7
FFICIAL
[FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
JO
07* *50.00
* 50,00
* 50.006
E *0,00
839.75
11-27-79
5 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
.1'1L-27-7.9
839.8z *50.00c°_,J-
c.
c
1-
c
2
h'ODomer CIID ICCII .NI('F