1979, 08-29 Permit: 79-3082 Reside, ReroofPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
CHANGE OF USE FROM
TO
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
Split Entry
JOB AD/DRESS
Rancher
LEGAL DESCRIPTION - SEE ATTACHED
lew 6
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> J
LOT
BLOCK
1:1MVE.F
PARCEL NUMBER/S��
2.
No. Rooms
ISUBDIVISION
OTHER
❑ POOL
O N
PHONE
�
3.
L
Req'd.
C
TU)47 b
A &DRES.5
of EXEMPTION
ZIP
Required Set Backs in Feet
^�
d _�
North South East I.West
8
CONTRACTOR
FEES COLLECTED
PHONE
Size of Parcel
Zone Classification
9. L 00 f� Utilities
Single $
A6Ktcµt_ L_ 5 t48
4.
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building1_
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
ADPRESS
ZIP
Type consT7
Occupancy
Sprinklered
DATE P-%
SIGNATURE
Mech.
SPECIAL APPROVALS
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
�J.
SEPA
Planning
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
I Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
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A/
TYPE ❑NEW 1:1 ALT. ElAD'N. El RPL.
1:1MVE.F
No. Baths
No. Floors
No. Rooms
Rec. Room
7. OF
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M. H.
OTHER
❑ POOL
CERTIFICATE
Req'd.
I Recd.
Not Req'd.
of EXEMPTION
DESCRI,QE WORK
8
FEES COLLECTED
VALUATION Source f GAS
ELECTRIC WATER SEWER
9. L 00 f� Utilities
Single $
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
Building1_
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 nstruction or the
performance of construction.
Plumbing
— —7t? 7
DATE P-%
SIGNATURE
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
vtw�
SEPA
Planning
Fire Marshall
Mobile Home
Co. Engineer
Other (Specify)
Utilities
Q f
TOTAL $ C_
Zone Clearance
WHEN MACHINE VALIDA7
SEPA Checklist
Pay
DATE %-71? OFFICIAL&J& �i/.f JCL
THISIBECOMES A 7ER MIT.
) - 2
PERMIT NUMBER
7q - SO,?
DATE
02* *19.00
* 1 9,00
* 1 9.001,
E *0,00
30819
08-29-79
;? 6479.
IN THIS SPACE,
R�"
*19,002f�