1980, 02-07 Permit: 80-984 Relocate BldgPLAN NUMBER
7
w
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE VYORK
FEES COLLECTED
s.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
!21L-10-1, 6-V oN 11b
j15 EjA DDRESS
VALUATION
LEGAL DESCRIPTION SATTACHED
T
ISUBDIVOION
3ESE
PARCEL NUMBER/S
-- O
2.
I
0 7� O�
OWNER
PHONE
LJ 8.7593
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
D'r� I T �I
3.
Building
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
AgDRESS I /�
`NI
ZIP
6
Req iredet Backs in Feet
pS 3 v
35
,
C/UIII
SPECIAL APPROVALS
North v South East West
CONTRACTOR
DEPT. REQ'D. RECD.
PHONE
Size of Parcel Zone lCCll as sificatio
1
4.
✓�j
-:f
ADDR SS
ZIP
Type Const. Occupancy Sprinklered
-]Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
_
5'
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE NEW
1:1 ALT. ElAD'N. El RPL. ElMVE.
7,
OF
El OTHER
CERTIFICATE
Req'd.
Recd.
Not Req'd.
t,BLD. ❑ PLMB. ❑ MECH: ❑ M.H. El
WORK
of EXEMPTION
DESCRIBE VYORK
FEES COLLECTED
s.
!21L-10-1, 6-V oN 11b
VALUATION
Source GAS ELECTRIC WATER SEWER
g, 2-5001
Ut�ties
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
G� _
�v
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
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.
Plumbing
J �S% SIGNATURE�_^^�R� �� e�-� --
DATE IL�� -
Mech.
SPECIAL APPROVALS
SP'E�CTp7L CONDITIONS:
DEPT. REQ'D. RECD.
r1( I vki r5l l jJ
Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer "� L -P ow�ey,
Utilities -
Zone Clearance
SEPA Checklist
DATE 1-- -i 10OFFICIAL-41
f/ 1
SEPA
Mobile Home
Other (Specify)
A
_r
PERMIT: NLMB>!R
DATE
02* *38.00
*3(U 0i
826;9
02-01-80
6479.
2 d-�O
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS D COIXIF,..rS,A�ERMIT. 9
0 ,
*�n.DD°�
f - PERMIT NO.
Spokane County
Planning Department
Short Plat
Exemption Certificate
1. WAS THIS PARCEL SEGREGATED BEFORE MARCH 13, 1978, OR WAS APPLICATION
TO SEGREGATE MADE BEFORE MARCH 13, 1978 ? YES NO
(exempt under section 3.3B5 of Short Plat Ordinance)
2. IS THIS PARCEL 10 ACRES IN SIZE OR LARGER ? YES
(exempt under section 3.3E of Short Plat Ordinance)
3. WILL THIS PARCEL BE USED FOR A PUBLIC UTILITY FACILITY ? YES
(exempt under section 3.384 of Short Plat Ordinance)
4. IS THIS SEGREGATION BEING ACCOMPLISHED TO EFFECT A MINOR BOUNDARY
OR PROPERTY LINE ADJUSTMENT, BUT NOT CREATING ANY NEW LOTS OR
CAUSING OTHER LOTS TO FALL BELOW MINIMUM ZONING STANDARDS FOR SIZE
SHAPE OR FRONTAGE, OR AFFECTING ROAD ACCESS TO ANY OTHER LOTS ? YES
(exempt under section 3.3H of Short Plat Ordinance)
5. IS THIS PARCEL ZONED RESIDENTIAL OFFICE, LOCAL BUSINESS, COMMERCIAL, /-)
FREEWAY COMMERCIAL, INDUSTRIAL OR MANUFACTURING ? YES C0'
(exempt under section 3.384 of Short Plat Ordinance)
APPROVED BY: �—�'f' DATE: / ! / SO
I hereby cert'fy the nswers I have offered in connection with obtaining
this exemption are true..........
APPLICANT'S SIGNATURE: -� DATE:y
4
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