1979, 07-19 Permit 79-733 Replace Roof TrussesPLAN 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 V��jJDRESS eT 17711
6\041'
LOT '" BLOCK SUBDIVISION
3
4.
OWNER
11M51-1 1'1
ADDRESS
1�, 1 7711 i017l/W
vorve
ADDR Sr� •'� <i -
DESIGNER
ADDRESS
PHONE
ZIP
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL,NUMBER/S
Ib-31r-56'
Required Set Backs in Feet
North 'South��
Size of Parcel
Valuation
DWL Area I Basement Area
East Ip' 'West
ZZne Classification
C�c„
Spr nklered
Des No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
,❑NEW ❑ ALT. ❑ AD'N. LLT RPL. ❑ MVE.
LYJ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
9.
DESCRIBE WORK
VVirTk 17AH
1950
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 go g this
type of work will be complied with whether specified herein or not. The gr. 'ti •g of a permit do-: not . esume
to give authority to violate or cancel the provisions of any other state or .cal .w regulatio� ruc '.n or the n
performance construction.
DATE
DEPT.
CIAL APPROVALS
REC'D. REC'D.
SIGNATU
Env. Health
Planning
X/9
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE1/ 1/ /9 OFFICI
FEES COLLECTED
Single $
Building �1 r 00
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
PERMIT NUMBER
`7y -
DATE
02* *31.00
*31.00 n
*31,00'8
A *Q00 n
73122
07-19-79
A 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-19-79 73,3c) *31000J
APP'.1YI FIR ISSUANCE
4
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