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1979, 11-14 Permit: 79-7815 Residence(PLAN NUMBER 3 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 3 JOB ADDRESS 1 CI LOT BLOC zt). LEGAL DESCRIPTION — SEE ATTACHED SUBDIVISI N ADCESS v 0 4. CONTRACTOR PHONE Qa-i-i5 3 ZI P gg21 PHONE PARCEL NUMBER/S --?.,e.34I C1)-03 ` b t t(4)gylcd‹.114-1) Required Set Backs in Feet North [South 'Z.' .(, [East 1.3Z' (West 30� ADDRESS ZI P Size of Parcel 1(0.5". (-431 Zone Classification Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. DESIGNER CHANGE OF USE FROM 6. TO PHONE ZI P Valu ion Building Area in Sq. Ft. rp for, IpOO DWL Area Basement Are (jTa Garage I Sto P,Lice Lib Split Entry soil Level Rancher TYPE 7. OF WORK I NEW Y" BLD. ❑ ALT. ❑ PLMB. ❑ AD'N. ❑ MECH: ❑ RPL. ❑ M.H. ❑ MVE. ❑ POOL El OTHER No. Baths No. Floors No. Rooms Rec. CERTIFICATE of EXEMPTION Req'd. Rec'd. Not Req'd. PERMIT NUMBER 7i/5 DATE DESCRIBWORK ' v VALUATION 9. LIS Sodree of Utilities GA C Ute` ELECT WIC x 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 governing this type of work will be complied with whether specified herein or not. The granting of a permit does not to give authority to violate or cancel the provisions of any other state or local law reg ating co performance of construction. DATE SIGNATURE DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning Y2x(//3/7 7 Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist FEES COLLECTED Single $ SPECIAL CONDITIONS: • DATE/i--nOFFICIAr.��( /( APPROVED FOR ISSUANCE Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ 02* *27800 *27800 *278.00 B *0.00 8 781.42 11-14-79 2 6.479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 1'1-`l4'-79 781.52 *278.002 0 U W 341,`0 ` -----fir-- ! Z' I II 1 1 1 1 r r 1 I 4, 1 1 1 1 r 1 I 1 1 1 1 4it L4 Iii 44.1; e S �AAv+ 4 041 441;1100#1 Zfr s- 41 vz O Sc4 l0 r= 141 , --4---. 1 `! ! 13vw NS "Rd. -4- 2z1-6 If 4 it z-6