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1979, 08-28 Permit: 79-2978 MHPLAN NUMBER 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 JOB ADDRESS 1. e qza 7'fJ.�f 'ci Gl r cP LOT BLOCK B LION 2. OWNER 4. 5. LEGAL DESCRIPTION — SEE ATTACHED D R E56 ?°D.sj J �StaS 2 CON RAC OR 44441— ADDRESS DESIGNER DESIGNER 4tP PHONE b.ti/— 7/46 ZIP PHONE S PHONE ZIP PHONE ADDRESS ZIP PARCEL NUMBER/S j7. ; 2—/ 09 Ah.'LOD .5.44007 s. Exc., 5Tl26.E75 01-K Jie) d PPDRTUN/TN Required Set Backs in Feet / n � / / North P rc (South i 43 East 2,27 West ��� Size of arcel Zone Classnccatio /9� x arm -69. -1 -en if.<r..L Type Const. Occupancy Sprinklered ❑Ves DNo D Req'd. Valuation Building Area in Sq. Ft. 2 SLD / DWL Are Basement Area Garage Area Storage Q CHANGE OF USE FROM 6. TO Split Entry Split Level Rancher TYPE 7. OF WORK [1_NEW 0 ALT. ❑ BLD. 0 PLMB. D AD N. 0 RPL. D MVE. ❑ MECH. M.H. 0 POOL 0 OTHER No. Baths No. Floors Rooms Rec. Room 1414,1•41 • Req'd. I Rec'd. CERTIFICATE of EXEMPTION NotyRreq'd. DESCRIBE WORK 8. VALUATION eV 9. fkjDd °L Source S LIQ E ECT rLP GAS IMOD ��T jIC WATER Utilof ities A/ MODERN 6cF�TRIG ,ELser.oLP_ p SEWER 1L1A!/i 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 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 •4lr cal law regula 'ng construction or the performance of construction. �[ DATEppp-..�-•D-77 SIGNATURE r' DEPT. SPECIAL APPROVALS REQ'D. REC'D. Env. Health Planning pD8'x7/79 Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPECIAL TIONS: art, orw1P- er-r-S. DATE OFF APP AL FOR ISSUANCE FEES COLLECTED Single $ Building Plumbing Mech. Plan Check SEPA SMobile Home J, Other (Specify) TOTAL PERMIT NUMBER DATE 07* *1500 * 1500 ti * 115006p A *0.00 8 297.7& 2 64.79. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 0 8''7"2i&r:17 9 2 9 7:8 5 *'15..0,0 2. 0 0 W d CO 4'! )LLEN f OMO • pg pOSED MNDM 127 /93 /F WHY S' CWR!? IS"rot �x/STlN& 67-6. R44 ig R 1PRr of itY/77 S �l1/ A vENvr VI/ Lo �0Al- b PE 't ITN Spokane Coannty Panning Depaartctent Sh©rt Plat Exemption Certificate 1. WAS THIS PARCEL SEGREGATED BEFORE MARCH 13, 1978, OR WAS APPLICATION TO SEGREGATE MADE BEFORE MARCH 13, 1978 ? (exempt under section 3.385 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 ? (exempt under section 3.3H of Short Plat Ordinance) 5. IS THIS PARCEL ZONED RESIDENTIAL OFFICE, LOCAL BUSINESS, COMMERCIAL, FREEWAY COMMERCIAL, INDUSTRIAL OR MANUFACTURING ? (exempt under section 3.384 of Short Plat Ordinance) APPROVED BY: ,RD/4L 4zt YES NO 24( YES /N(\ DATE: 8 /4e 177 I hereby certify the answers I have offered in connection with obtaining this exemption are true li1/4141i I ' f n! M{ APPLICANT'S SIGNATURE:' DATE: B /.d / 79 y,,,I u NSM p 111 WISON SIRECI §(.91.(A!O wASniNGR#$ 99100 rnont 4bP-z..:,