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1979, 11-19 Pemrit: 79-8124 ResidencePLAN NU BER 3 APPLICATION/ PERMIT SPOKANE COUNTY - BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 S. DE CRIB,E WOR; VC/ - 1V r VALUATION Source GAS ELECTRIC WATER SEWER //of U 9. Y� ©O Utilities 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 or cal law regulating construction or the performance of construction. DATE SIGNATURE SPECIAL APPROVALS DEPT. REQ'D. ^ REC'D Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPEC CONDITIONS: �,yy� fLM jTAgf FEES COLLECTED Single $ 2 P% Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) - 01 PERMIT Specify) 0PERMIT NUMBER DATE %/—/2— 7% * r, 11-i�-14' 6.47 TOTAL $ WHEN MACHINE VALIDATED IN THIS SPACE, IPWA/�(�� THI$B,`f COMES APERMIT. . DATE FFICIAL�AY�'1h�+ APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 1. B ADD ESS / , LEGAL DESCRIPTION -SEE ATTACHED LO LOCK ISU13DIVISION PARCEL NUMBER/S ��w� O ✓ I6541-- �� [if �� OWNERK G 1 P/ -1� V ADDRESS I� y,/� ��A ZIP ijo in v 0-7 YJ NorrthRequire1S(Backs Southeet East West CONTRACTOR � PHONE Size of Parcel Zone Classification 5� 4' ADDRESS ZIP Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq Ft. 5. _:�7' ADDRESS ZIP DWL Area Basement t Area Gare Storage 117 CHANGE OF USE FROM TO Split EntrySplit Level Rancher 6. � TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. No. Baths No. Floors No. Rooms I Rec. Room 7, OF„_,/ ❑OTHER WORK BLD. E)PLMB. ElMECH: ElM.H. ❑POOL CERTIFICATE Req'd. Recd. Not Req'd. of EXEMPTION S. DE CRIB,E WOR; VC/ - 1V r VALUATION Source GAS ELECTRIC WATER SEWER //of U 9. Y� ©O Utilities 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 or cal law regulating construction or the performance of construction. DATE SIGNATURE SPECIAL APPROVALS DEPT. REQ'D. ^ REC'D Env. Health Planning Fire Marshall Co. Engineer Utilities Zone Clearance SEPA Checklist SPEC CONDITIONS: �,yy� fLM jTAgf FEES COLLECTED Single $ 2 P% Building Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) - 01 PERMIT Specify) 0PERMIT NUMBER DATE %/—/2— 7% * r, 11-i�-14' 6.47 TOTAL $ WHEN MACHINE VALIDATED IN THIS SPACE, IPWA/�(�� THI$B,`f COMES APERMIT. . DATE FFICIAL�AY�'1h�+ l' '� s got T _ C lla?N E ----------------