1979, 08-13 Permit: 79-2079 Re-InspectPLAN 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
5
LOT
VercdgkQ
LOCK CeVISIO e 1/44-1:4-
-1 ,(
BLOCK SUBDI VISIO
--`Z s„11rda
2. 3 - n, --\Q ° - -
OWNER
3. Rc3t tr. __o h&CC-kr-Ara. Soc-\.tin
ADDRESS
5 1 So `1- cer 4-uNj
CONTRACTOR - ---- - --- --- - - --
So n ckc.c-rvnS Cc rN ,k-ra . i en
ADDRESS _ _ .. _ .
2- 1532 Trct- -
DESIGNEftr� ac C J
5. ADDRESS
sn> -- -u� - - - --
4.
_—LEGALDESCRIP_T.ION=SEE_AT_TAC .
P RCELNUMBER
oc-fico o - Z35L14- i101 ckna
PHONE
428 °I M 18
LOV. 3 3ic _K, 2
ZIP
ct cto
PHO
Required Set Backs in Feet
North 'South
East 'West
PER IT NU R
(J reyi.m07fr.
DATE
-- — T1,g ,r,llp'p-p-
HEO_—_ _ *1000 En'
ts2
*10,006
EI — *ppp 8
20782
9 6--734-1`
Size- of Parcel-- -
'jc7 K (5C)
21P
�icI 2-16
Type Const._
PHONE
ZIP
- 4 Rall.--
—_
Zone -Classification 1 y5t5%14 41C-Cetmit on\eSiAfv}, 101
,�S/prinM_eretl _ _
W
Yes No 0 Req'd.
Occupa
�eS
Valuation
+-Y3-y 0-1° -- -
L Area l Basem; nt
V1
ncy
Building Areaiiin Sq. Ft..
I ti
Area Garage
Storage
CHANGE OF USE FROM
6. N/A
TO Ai 1,4
Split Entry
SplitLevel
Rancher
TYPE NEW 0 ALT. 0 AD N. 0 RPL.
7. OF
WORK 0 BED. —C7 PLMB. ❑ MECH: D M.H.
0 MVE.
O POOL -
OTHER
DE
S.
IBE WO K _
cas
GA I, -T,' ELECTRIC WAT R
Y kafiCfii)fn - - SyIit..c—
VALVA ON
9.N1�
Source
- of
Utilities
No. Baths
No. Floors
L-
No. Rooms
6
Rec. Room
-- --CERTIFICATE -- --- -f-Req'tl.
of EXEMPTION
/
- Rec'd. -
Not Req'tl.
- - -- FEES COLLECTED— ---
SEWER
;A:;CtickC
I hereby certify that I. have read and examinedthis_application and.have read the "NOTICE".provisions.included
on reverse side, and know the same to be true and correct. All p . ISI0 of laws andd,,Ors ..nc- eoverning this
type of work will be complied with whether specified herein or ot. The wanting of per . Rot presu -
to give authority to violate or -cancel the -provisions -of any-othe state or cal (law re ulatinl ..nar.t
performance pf coFstruction.
DATE Yl I N I I % SIGNATURE
Single
DEPT_
SPECIAL APPROVALS- - -
REQ'D. REC'D.
Env. Health_
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
-SPECIAL CONDITIONS:
---
�J' 1' — - —
,e% //-. �,e2C, )/ fylo ile Home
,e,MgJQ-7(,ri �,✓
p,,—e`er, -,,n v,.r119 they Spec ifv)�D
SEPA
DATE r/ // 'OFFICIAU41 - J-1/NNtw
APPROVED FOR ISSUANCE
TOTAL $ /Q ora
Fri' -F
WHEN MACHINE'VALIDATED IN THIS SPACE,
THIS BCOMES AP MIT.
0 -Bt 1.131,77'
207.92 *10,ODti