1979, 07-16 Permit: 79-484 MHPLAN N MBER,
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
BLOCK SUBDIVISION
LOT
20-z4
OWN—R
3.D D R ESl�►c-t .01i /
ADDRESS
// IA) z87
CONTRACTOR
/3
LEGAL DESCRIPTION - SEE ATTACHED
4.
PHONE
487-.s'7/
ZIP
9.-0 3
PARCEL NUMBER/S
A.0 7-6
ars 7Hieu :." i3/J( /,3
f it4eR7 aN ADD
Required Set Backs in Feet
North (South
East (West
PHONE
ADDRESS
DESIGNER
5. ADDRESS
ZI P
PHONE
Size of Parcel Zone CI ssification
/..6—.0 x .i- 2 i " altarcf,,c,e,ftc,-14, cc -
Tm.e Const.
Valuation
ZIP
Occupancy
1 667 USDea
Sprinklered
❑Yes ❑No D Req'd.
Building Area in Sq Ft.
36
DWL Area I Basement Area I Garage Area
/ 350 /3.SD' illeA/-t'
Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
X
7.
❑ BLD. ❑ PLMB. ❑ M CH: ❑ M.H , ElPOOL
DESCRIBE WORK
8. 73 l . -te%t. -
WATER
TYPE
OF
WORK
❑ NEW ❑ ALT.
❑ AD'N. ❑ RPL. ❑ MVE.
E OTHER
No. Baths
2
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
V,LUATION
9. 66 0,00e
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of construction.
7- -79
Source
of
Utilities
DATE
GAS
ELECTRIC
SEWER
�eyQ�CciL�
examined this application and have read the "NOTICE" provisions included
to be true and correct. All provisions of laws and ordinances governing this
whether specified herein or not. The granting of a permit does not presume
the provisions of any other state or local law regulating construction or the
SIGNATURE
SPECIAL APPROVALS
DEPT. REQ'D.
RECD.
Env. Health
Planning
7-:j - 7?
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
REPL OE.3 PFRMfT N. M —P`f85
DL4PLE$ WAS NEVER- .BU IL I .
PA ANS ow- 7-6-7?
{). g 1—icy '9 g— A.
DATE 746-7g OFFICIAL? 74 Q dth
APPROVED FOR ISSUANCE
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $
DATE
PERMIT NUMBER
1q- 4
02* *6600
*66.00 V)
*66006
A *0.00
48.32
07-16-79
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-16-79
48.42
*66,00°.H