1979, 08-24 Permit: 79-2740 Demo Residence.• PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH B11 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
1. Si6T 7-� C
�"/
lif-7-L2�
2. (LILOCK
-S
3.
LEGAL DESCRIPTION - SEE ATTACHED
SUBpIV/(2-4-44...411.17:4-74.) l.teie t VT-.t.&t./(.L,64•61 C
0,14yJ E R n�
ADDRESS [,,jl' �p n
/U L.Z (CP& �.iaT,e ACJ 6-6/1a—
CONTRACTOR4.
PHONE
9 <24,-4?.,s4
PARCEL NUMBER/S Lf/,{_ /S.Slic
AD RESS
ZIP
99.2DG
PHONE
ZIP
DESIGNER
b. ADDRESS
PHONE
ZIP
Required Set Backs in Feet
North 'South East 'West
Size of Parcel Z e Classification //
Type Const. Occupancy Sprinklered
❑Ves ❑No ❑ Req'd.
Valuation Building Area irsl. Ft.
git
OWL Area I Basement Area Garage Area Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split
tLgve
14141- lll
Rancher
Ailft/AW
TYPE 0 NEW
7, OF
WORK 0 BLD.
❑ ALT.
-❑ PLMB.
❑ AD N. • 0 RPL. 0 MVE.
❑ MECH: 0 M.H. - 0 POOL
OTad
HER
No. Baths
No. Floors
.2
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
8. DESCRIBE WOR 41
/ GAS ELECTRIC
VUATI ON
S�
9.
Source
of
Utilities
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 presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
DATE /1 c2;3 -7 9 SIGNATURE�v+�,�• -lt�•!P-civ.
DEPT.
SPECIAL APPROVALS
REq'D. RECD.
Env. Health.
Planning
Fire Marshal/
Co. Engineer
UtiI ities
Zone Clearance
SEPA Checkllst
SPECIAL CONDITIONS:
DATE /T2--,-79OFFICIAL /IIA.U.1Q�
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
�
r
J
ses
PERMIT NUMBER
79 -.27 'id
DATE
02*
E
2739B
08=2479
2 6479.
*500
*500
*5006
*000 8
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08i=24;;'7,9
2(4'02
*,S. O 0 a°O 1-