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1979, 08-10 Permit: 79-1955 ResidencePLAN 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 ADDRES I (6 61 LOT BLO K 2. Avo- LEGAL DESCRIPTION - SEE ATTACHED OWNE4R. �K 3. ADDRESS K T 1 E 0 Fill Nil CONTR CTOR 6i-Nc,i 4. ADDRESS UBDIVISION' ' M A120 PHONE PARCEL NUMBER /S [viztiot.4 of 0 75-F f- IG I (6,I f I &b2-1 1 6 9 Required Set Backs in Feet r1 North 6'(.J 'South' 0 [East 7-'2. (West PHONE (P)7- -O3�-3 ZI P Size of Parcel Type Const. Occupancy Zone Classification Sprinklered ❑Yes ❑No ❑ Req'd. 5. DESIGNER ADDRESS PHONE ZIP Valuation AV4rea CHANGE OF USE FROM 6. TYPE 7. OF WORK TO Split Entry Building Area in Sq. Ft. 1 Garage Area lit L evel Storage Rancher III N W ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ OTHER BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL Noths No. Floors No. Rooms Rec. Room CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. 8. DES RIB WORK VALUATION 9. &a t 00° 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 gr.' ping of a permit does not presume to give . thority to violate or cancel the provisions of any other state o to law regulating constructio +r the Source of Utilities GAS_ ELECTRIC WATER «ri2O.' SEWER perfor r a ce f construction. / V DATE DE T. SIGNATURE SPECIAL APPROVALS REQ'D. Env. Health Planning Fire Marshall Co. Engineer RECD. tie. ›- z s Zone Clearance SEPA Checklist SPECIAL CONDITIONS: .P,Qo,I,0 e--10-7? 6 DATE 7";,f' OFFICIAL APPROVED FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 0'.00 DATE PERMIT NUMBER 79- )95-5 02* *97.00 *97.00 to- * A *G00 13212 07 -31 -79 2 6479. WHEN MACHINE VALIDAT IN THIS SPACE, THIS BECOMES A PERMIT. 08 -10 -79 i95.5z *97,00 °� DATE REMARKS ti J RECORD OF INSPECTIONS Final Inspection INSPECTED BY QRdd Od-2J -.16 1251% V .000 g 4,6s00R oS00 OS* .d. 0C