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1979, 10-11 Permit: 79-5785 ResidencePLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE PEkMIT N'-MBER 02* *211.00 *21 1.00 *21 1.00 E *0.00 S 578,48 10-11-79 .9 6,479. DESCRIBE WORK APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES FEES COLLECTED JOB ADDRESS VALUATION LEGAL DESCRIPTION — SEE ATTACHED GAS LOT BLOCK SUBDIVISION 5�- PARCEL NUMBER/S 2. Single $ 1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included know be All laws N E type of work will be complied with whether specified herein or not. The granting of a permit does not presume PHONE to give authority to violate or cancel the provisions of any other state or local law regulating construction or the 3. zy/` /S 50 SPECIAL APPROVALS SPECIALCONDITIONS: ADDRESS Env. Health%Q ZIP Required Set Backs in Feet Planning ) �06 Fire Marshall Mobile Home /� 1 1J- J �� j 2 l �7 North � Lam— Utilities TOTAL $ Zone Clearance South East West 1 -"1 I Y/ " % - CONTRACTOR DATE O F F I C I A I�-.iti' � 1 l�.iC.L�--"'� ,� PHONE Size of Parcel Z Classification y� r� 4' ,/rte ADDRESS ZIP Type Const. Occupancy Sprinklered /�� I 3 ❑Yes 41\10 ❑ Req'd. DESIGNER PHONE Valuation BuildingP� in q. Ft. 5. ADDRESS ZIP #Area BasemenLArea GarraagArea Storage CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. TYPE .NEW ❑ALT. ❑ AD -N. ❑ RPL. ❑ MVE. No. Baths No. Floors 3 No. Rs Rec. Room %. OF OTHER ❑ OTHER WORK BLD. WORK ❑ PLMB. ❑ MECH: ❑ M.H. CERTIFICATE Req'd. Recd. No d. of EXEMPTION DATE PEkMIT N'-MBER 02* *211.00 *21 1.00 *21 1.00 E *0.00 S 578,48 10-11-79 .9 6,479. DESCRIBE WORK 8 �� ����� FEES COLLECTED VALUATION Source GAS ELECTRIC WATER SEWER 9. S �d© of Utilities (� [`7`� Single $ 1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included know be All laws on reverse side, and the same to true and correct. provisions of 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 Plumbing performance of construction. zy/` DATE SIGNATURE Mech. SPECIAL APPROVALS SPECIALCONDITIONS: DEPT. REQ'D. RECD. Pian Check Env. Health%Q SEPA Planning Fire Marshall Mobile Home Co. Engineer Other (Specify Utilities TOTAL $ Zone Clearance WHEN MACHINE VALIDATED SEPA Checklist THIS BCOMES A PERMIT. (/ IN THIS SPACE, j 1 -"1 I Y/ " % - / f� , 6.5 * L 11. U 0 i,l f-1 DATE O F F I C I A I�-.iti' � 1 l�.iC.L�--"'� ,� 4C IC 6 0 all r )0 , N-1 -Tf -71