1979, 07-18 Permit: 79-621 AdditionPLAN NUMBER
JOB ADDRESS
�. N Z3Z
OWNER
3. FM LLk
ADDRESS
N� 232
CONTRACTOR
4. 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
/-ILY P -OAP LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION PARCEL NUMBER/S PTt4 of: 5"6K 4, Dc -5, 4.s FDL.
12 -53Y - 0 51 I N_ G6 'OF W loo OF E. kZc)' F xc- aIECI AT NF—:
PHONE C�of; OF `Tl. T14 'S, Z3 ' i -I+ N To PT'
3'74
Z3' W. OF NE cR `oR E -m fW Ly
Or 8E.
-T'2 ZIG c �,2To-
ZIP Required Set Backs in Feet
LILY ROAl2l Q North South East West
PHONE Size of Parcel Zone Classification
I
66' k o5 -- SUE
ZIP Type Const. I Occupancy Sprinklered
U— ❑Yes ❑No ❑ Req'd.
PHONE Valuation Building Area in Sq. Ft.
CHANGE OF USE FROM ITO
6.
6Z S.4
ZIP DWL Area Basement Area Garage Area Storage
— _ _—
Split Entry Split Level Rancher
X
�� No. Baths No. Floors No. Rooms Rec. Room
TYPE El NEW El ALT. 16AD'N. 1:1 RPL. ElMVE.
sHoWe 1 0
], OF El OTHER
WORK COLD. ElPLMB. ElMECH: 1-1M.H. ❑POOL CERTIFICATE Req'd. Recd. Not Req'd.
of EXEMPTION Y
DESCRIBE WORK
FEES OL E
DATE
PERMIT NUMBER
02* *21.00
*21.00
*21,00
B *0.00
6208
07-18-79
2 6,479,
8
1 C L CTE D
GAS ELECTRIC ATER SEWER
VALUATION
Source
V
gg XIS INc,
9• ZSDO
utilities
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
00
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
P 9 9 Building /�
type of work will be complied with whether specified herein or not. The ranting of a permit does not presume
to give authority to violate or cancel the provisions of any other state o I al law re lating construction or the
performance of construction. Plumbing
DATE 1D — '7!Z SIGNATURE
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.N Plan Check 7-
/ b 7
Env. Health
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities tN
TOTAL $_
Zone Clearance
WHEN MACHINE VALIDATED
IN THIS SPACE,
SEPA Checklist THIS BE�COMEpS A PPE(]RMIT.
�L��
1— O—/ 7
DATE OFFI
6 G 1 Z
*2 1.1J q aO --'
I
N