1979, 10-03 Permit: 79-5232 ResidencePLAN NUMBER
2-2h
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4563675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS ! -"' 14.19
81., uFF 142.111E -
LEGAL DESCRIPTION - SEE ATTACHED
LOT :LO K
3
OWNE
N9jk
SUBDIVISION
MVA F'Ar. /\nbi -1 o,N1
PHONE
q26 -4? -72 -2 -
PARCEL NUMBER/S F-0.4 N CF 20 543 -c ozq
ADDRESS
SCS
2,oI,Iv (115-- t2/\L,L
4.
CONTRACTOR
ZIP
'io37
PHOE
Required Set Backs In Feet
/� I
North � �South� East Zo west p I
Size of Parcel Zone Classificati9Ja
e2*x14-c
ADDRESS
ZI P
Type Const.
V -N
Occupancy
R.-3
-1/ f Sprinklered
Eyes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuatiop
ADDRESS
ZI P Area
CHANGE OF USE FROM
6.
TO
LQ , IOU()
a
Building Area in Sq. Ft.
- 1, ��ii f Basement l
�aEntfr�t� �,
Garage Area
Storage
Split Level
TYPE
7. OF
WORK
tL,.T NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
LJd'BLD. ❑ PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. RoomsIC
Rec. Room
Rancher
r r
PERMI` NUMB4R
79 —S243 -Z
DATE SEP7 t7!fq�9
02*' *31000
*31Q00 i
*310,006
•E *0.00
5231
10-03-79
2 6.479.
TWO Si,
i
CERTIFICATE
of EXEMPTION
Req'd. Rec'd.
Not Req'd.
8. DN - _._-11,4 L i l y1 � l t/i INVA I TA tf-4,/!] `/'�VALUATION Source GAS ELECTRIC � ER SEWER _
of NA t° l
9. �� f�Gl Utilities V
I hereby ccccertify`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 // !t --/ 7 —7! SIGNATURE // e !Li14&
SPECIAL CONDITIONS: 6
SPECIAL APPROVALS
DEPT. REQ'D.
REC'D.
Env. Health
Planning
y 2s 79 gLLI,s y
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
17140\1 kvrtici-H
cr r r�
11 W SDt PLANkrAG 5D'
o Wye
A500460
Hano
DATE
OFFICIA
APPROVED FOR ISSUNCE
FEES COLLECTED
Single $
Building' 0 /
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 3�d
da
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1,0,.031-79
523,25 *'310.0.0°