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1979, 10-18 Permit: 79-6265 MH]PLAN 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 QA w LEGAL DESCRIPTION - SEE ATTACHED 4,&AR-A Qkl LOT BLOCK DIVI ION PARCEL NUMBER/S 2. 1 C L01A L- dN 44115� rL A OWNER /� ,p P 3. �_ Llr� I4c, CD� f�� Of ADS ss z CO AC OR PHONE 4. ADDRESS ZIP DESIGNER PHONE 5. ADDRESS ZIP .3 CHANGE OF USE FROM TO 6. TYPE NEW ❑ALT. ❑ AD'N. ❑ RP ❑ MVE. % OF WORK El BLD. 11PLMB. 11MECH: El POOL ❑OTHER 8. DES GR,IB WORK Required Set Backs in Feet Source 10 30 lWest 30 North South East Size of Parcel Zone Classification ri Co. Engineer Type Const. Occupancy I Sprinklered E ❑Yes []No ❑ Req'd. Valuation Building Area in Sq. Ft. $ DWL Area I Basement Area Garage Area Storage Split Entry Split Level Rancher No. Baths No. Floors No. Rooms I Rec. Room CERTIFICATE Req'd. Recd. Not Req'd. of EXEMPTION FEES COLLECTED VALUATION Source CAS E ECTRIC WATER SEWER 9. 1&I 000 of Utilities Co. Engineer Utilities / 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 cal law regulating construction or the performance of construction. / c DATE >F b ^ R�% SIGNATURE DEPT. SPECIAL APPROVALS REQ'D. RECD. Env. Health / Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: eop--fi r- �%WrC514�, cy--45r�lltl' 27744--� Single $ Building Plumbing Mech. Plan Check SEPA Mobile Home �0 -©1-) Other (Specify) TOTAL $ (3PERMIT NUMBER ) 1 -75 DATE 07* *50.00 50.00 N *50,001 E *0,00 IS 6265 10-18-79 6479. I– OF WHEN MACHINE VALIDATED IN THIS SPACE, U THIS BECOMES A PERMIT. DATE'S ' t- i(1 `� C), U / ci * U. U L n 1 .= 14 L. r / - �® jw - "/Iyp-TAN14 o-' -s/ie 77. S_X /30 M 91 E E A 4elr R E S /30' �o 36 ' 30 pOO Gal paeK�Ny Slab • 0 6a` 3s� 0 o' /o Legal: The West 130 feet of the East 150 Feet of the South 77:5 feet of the North 310 Feet of Block 24 of Greenacres Irriga District Plat "A", As per plat thereof recorded in Volume "B" of Plats, page 21; Spokane County Planning Department Exemption Certificate 1. WAS THIS PARCEL OF LAND SEGREGATED BEFORE MARCH 13, 1978? (exempt under section 3.3B5 of Short Plat Ordinance) 2. IS THIS PARCEL 10 ACRES OR LARGER ? (exempt under section 3.3E of Short Plat Ordinance) 3. WILL THIS PARCEL BE USED FOR A PUBLIC UTILITY FACILITY ? (exempt under section 3.384 of Short Plat Ordinance) 4. IS THIS LAND TRANSFER, TO ACCOMPLISH A MINOR BOUNDARY LINE ADJUSTMENT, BUT NOT CREATING A NEW LOT OR CAUSINGREMAINING LOTS TO FALL BELOW MINIMUM ZONING STANDARDS OR AFFECTING ROAD ACCESS TO ANY NEIGHBORING PARCELS ? (exempt under section 3.311 of Short Plat Ordinance) 5. IS THIS PARCEL ZONED RESIDENTIAL OFFICE, LOCAL BUSINESS, COMMERCIAL, FREEWAY COMMERCIAL, INDUSTRIAL OR MANUFACTURING ? (exempt under section 3.384 of Short Plat Ordinance) STREET ADDRESS FOR BUILDING PERMIT : YE! ) NO YES P 0 YES �'P4 6 ,1 YES P0� YES NO I hereby certify the answers I have offered in connection with obtaining this exemption are true. Signature of Applicai ZONING: APPROVED BY: ��,� 5N ' N. Int HU 1N,. 4 /. 1 It f FL.RSON STREET SPOKANE WASHINGTON 99260 PHONE 456-22C5