1979, 12-18 Permit: 79-9263 Relocate ResidencePLAN NUMBER
JOB ADDRESS
1. r
LOT BLOC
2.
OWNER
3. G
AD�DR�ESS
lei—�
CONT
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
LEGAL DESCRIPTION - SEE ATTACHED
IV 151 NI PARCEL NUMBER/S
CHANGE OF USE FROM
6.
ZIP
PHONE
ZIP
TYPE 02'NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 OF WORK L'7 BLD. 1:1PLMB. ElMECH: 1:1M.H. 1:1 POOL
El OTHER
DESCRIBE WORK
in Feet
ize of Parcel
g15 X
'tom
Zone Classification
I� G .
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 11 Req'd.
aluation
Building Area in Sq. Ft.
DWL Area
Basement Area
Garage Area
Storage
Split Entry
Split Level
Rancher
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
Recd.
Not Re(
of EXEMPTION
8. � G ISO
G ��
VALUATION
Source
GAS
ELECTRIC
WATER
SEWER
of
Plumbing
DATE , SIGNA U
Q,
Utilities
SPEC AL CONDITIONS:
DEPT. REQ'D. RECD.
FEES COLLECTED
DATE
=D
PERMIT NUMBER
77 - 9-
02* *25.00
*2500
9262-4
12-18-79
6479,
HIS SPACE,
926,3]
*25.00a-�
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
Building � 1
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
performa e of construction. ,
Plumbing
DATE , SIGNA U
Mech.
SPECIAL APPROVALS
SPEC AL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health�filVPMLl
��pp►►I�
rW �� • oo
Planning
�r I�� Dow
SEPA
Fire Marshall09
1 -T
Mobile Home
Co. Engineer
Specify)
Other (Specify)-
Utilities
Utilities�ji
�v
TOTAL $ �' ✓
Zone Clearance
SEPA Checklist
!�
WHEN MACHINE VALIDAT
THIS B COM S A PERMIT.
1—� —� 9,
DATE ICIAL
DATE
=D
PERMIT NUMBER
77 - 9-
02* *25.00
*2500
9262-4
12-18-79
6479,
HIS SPACE,
926,3]
*25.00a-�
ACCESSORY BUILDINGS. Accessory building (garages, sheds, etc.) require a separate pe .
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land which are enforceable
through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE ,.fix; t
Name of Owner._Address LMLL -ii aRX � -a ---- Phone
�'.(rei�� � 0k-Lil�l��i �%{s
,Architect
Address_ Phone
. ,.. �
Engineer_ Address __ � 1 - Phone
Contractor_ t lily h( 1�r IiAi+1�i1S Address h7 7 X %�+-^ hlEr{!iJ Phone r� `"�►1}6
Legal Description of Property (Give complete descrip#ion from deed, tax receipt, etc.) Parcel Number.
k
DESCRIPTION OF WORK: New Addition. Remodel Moving Bldg. Zone .._ Fire Zone y
Size of Lot _-il-� i I s�• f"1' Sewage System ;�'iL.- CConst. —
(Fr., Conc.,'r.,etc. �,
Stories. Dimensions pol"t-3.2.4--- - Total Sq. Ft. Y- Valuation -N
Rooms -- Baths_- Basement u�±Foundation Const. CONMe' Chimney � '• replace —
(Ful!, part, nonel (Kin' (Number
Heat. System CLIU-X EA.Type of Roofing ,' kGLF_ Ext. Finish Int. Wall FinishUse of of Bldg. �^..i «. '=ItiLML-a h/u , W. &Alai F, No. of Units Bedrooms �-
t
ROADuNA� ', A Oroio '
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines. BbNV _';f -r $ 3W 13y State License No.
NORTH DILL K(7r-N
Ind. Ins. Acct. No.
fiESIDEML - COMMERCIAL
REQUIRED
Plumbing Permit
n� Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby c rtify information su iqed is correct and there are no other structures located on this property except
as sy n t I i
Owner or Agent Date
A LANIUSE OR STRUCTURE PERMIT .MIST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS ISNOTA PERMIT. E �; .: ARE NUN-REFUNL)ABLE ANU +140111-1-1i1ai+itil
s
DO NOT WRITE BELOW THIS LINE
Your street address will be __ fJ 10A LUN (t L(Al, The zoneel,,ueld
.J•i �i'.oa.,w
Sewage Permit Number-_-- __ Issued -_ Building Permit Receipt .0
Remarks ---- - - - - -- -----
u
vON I'r. AVE.
a.
•
�
r
r
Ind. Ins. Acct. No.
fiESIDEML - COMMERCIAL
REQUIRED
Plumbing Permit
n� Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby c rtify information su iqed is correct and there are no other structures located on this property except
as sy n t I i
Owner or Agent Date
A LANIUSE OR STRUCTURE PERMIT .MIST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS ISNOTA PERMIT. E �; .: ARE NUN-REFUNL)ABLE ANU +140111-1-1i1ai+itil
s
DO NOT WRITE BELOW THIS LINE
Your street address will be __ fJ 10A LUN (t L(Al, The zoneel,,ueld
.J•i �i'.oa.,w
Sewage Permit Number-_-- __ Issued -_ Building Permit Receipt .0
Remarks ---- - - - - -- -----
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