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1979, 12-10 Permit: 79-8886 MH
PLAN NUMBER DESIGNER 5. ADDRESS 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 LEGAL DESCRIPTION — SEE ATTACHED ' PARCEL NUMBER/S17 54-1 LOT BLOCK 2 � ISO OWNER N 3. (�� J O� ADRESSO }i ytt�7 ` v CONI/T�RACTQR, �"/Ir 4' lam/ ADDRESS DESIGNER 5. ADDRESS 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 N , 461<,AX9 LEGAL DESCRIPTION — SEE ATTACHED SUBDIVISION PARCEL NUMBER/S17 54-1 — I �z ;;?,©Q RHONE: (�� J O� }i ytt�7 ` v Z P Required Set Backs in Feet North � SouthEast 00 V s. West PHONE Size of Parcel Zo a Classlficat i n 12- .,LI P5 3 3 f3jQ . ZIP Type Co st. Occupancy Sprirfklered ❑Yes ❑No ❑ Req'd. PHONE Valuation Buildin jkr a in Sq. Ft. ZIP g— Area Basement Area Garage Area Storage CHANGE OF USE FROM TO Split Entry Split I 6. No. Baths I No. Floors TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7, OF „_/ ❑ OTHER WORK ❑ BLD. ❑ PLMB. ❑ MECH: CT M.H. ❑ POOL CERTIFICATE of EXEMPTION DESCRIBE WORK s. MO�I,0 x �o VALUATION Source GAS E ECTRIC WATER SEWER of 9, 0() 0 Utilities r/ i 1 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 performanc of construction. s DATE SIGNATURE SPECIAL APPROVALS DEPT. REQ'D. REC'D. Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL CONDITIONS: OAIL % oWHNe- PLAI d I tJl ISM K A--r-9V W DATE OFFICIAL ^^ .evel Rancher No. Rooms Rec. Room Req'd. I Rec'd. Not Rei FEES COLLECTED Single $ Building Plumbing Mech. Plan Check DATE PERMIT NUMBER 07* *10C.00 * 1 �)C.00 if7 8 5 6 3 11-29-79 x479. Q SEPA C ��.001 - u Mobile Home V z Other (Specify) TOTAL $ WHEN MACHINE VALIDATED IN THIS SPACE, THIS_B COTV A PWM IT. 1_ -1, 'S *100. !F 0 f 12.5 New STA ARD FORM LISTING CONTRA.�.T. LAND — — --- Add -ale Kal y -- �1 �' ` l r $ 10,50(1 mer s Name: Address _-_ R I Chard Jordan — —_ Fvj Front C1 • 1 res--- — --- — --- - -- IC ning ces 5 smts _ _ _ ter dal r.i n Ton Lono ins rt---- ��♦ — --- ---------------- - -- --- +t- _ Ido �4D u7 skit— " �ms_Ca5i1 —_ 0 N ei M 01,;l tg LP OFFICE OF THE SPOKANE COUNTY PLANNING DEPARTMENT Dare / 6 fig Building. Codes Department :,m - Planning Department _ `'_ bject-__ Buildinc,ZPermit Th Planning Department has received a request from eeap? Saila S for the release of a building permit on the property as described on the attach d affidavit/legal description. It has been determine that a building permit should be issued under the provisions of RCW 58.17.210. This memo and attached affidavit/legal description must accom- pany the building permit application. n d A A 11