1979, 08-28 Permit: 79-2980 MHPLAN 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 y71
e . / ;c1. -Z1
LOT
2. .3
OWNER m
Ac;:0DRESS
CONTRACTOR
4. ADD ESS
DESIGNER
BLOCK
j
5' ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION ff11 74 / 14t1 4.Zif
PHONEt/2H_7y83
PARCEL NUMBER/S 085-5Z-1 3o3
ZIP
94•Z/6'
PHONE
Required Set Backs in Feet �7
North 3Q 'South b3' lEast /
Size of Parcel
7o'X /17
i
West 7
Zone Classification I4O/Vk�
2 SIOe1 T7AL MBI L.
ZIP
Type Const.
V -N
Occupancy
Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
/3'f(
ZIP
DWL Area
/34-*
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
1�)Ot�l L i+ok4 Ei
TYPE
7. OF
WORK
grrIEW ❑ ALT. 0 AD N. 0 RPL.
0 BLD. 0 PLMB. 0 MECH: M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
v
8.
DESCRIBE WORK
141.0 -LL
VALUATION
9. -215 P00
41,f(_- cx 4_
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
sEPTic
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 I cal law re.Qulating cqnstruction or the
performance of construction. -A2C O 7'4.
DATE 8— x-� r 7`? SIGNATURE -1— r)
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
z/ 7
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
MoBI+-G ►-tor (PEi2M rr ND, J - 3 $ i't) prcmovEp
NEW MOBIi.t 14cME; i o ggpLisvc.r- AInt/E-
J 3811 MO8! 4 MI
M14'�
/01 7
DATE OFF AL
APPROVED"FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing -
Mech.
Plan Check
SEPA
00
Mobile Home 6
Other (Specify)
TOTAL $
PERMIT NUMBER
DATE ,INA 4 27-1 /q7'
07* *6600
*6600 N
*6600
A *Q00
297.9
08-28-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS,13COMEQS A E IMIT.
*66.00if'
c
1