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1979, 11-19 Permit: 79-8120 ResidencePLAN N - BER APPLICATION/ PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 8 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES VW d 7 / J A DRESS 1/Q �,Ikd ��, r Sourice GAS Of LEGAL DESCRIPTION - SEE ATTACHED ATE LOT I BLOCK '1SuBUivisioN 9, ` I (j V Utilities ' PARCEL NUMBER/S 2 Single $ I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included .. D '� on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Q type of work will be complied with whether specified herein or not. The granting of a permit does not presume OWNER Plumbing PHONE DATE ei �/ SIGNATURE _ �� " -" GA SPECIAL APPROVALS - DEPT. REQ'D. RECD. ` tr7 3. Env. Health /D ` `✓�� SEPA ZZ9- ADDRESS, Mobile Home ZIP Required Set Backs in Feet 0!0X� � Co. Engineer � � �, e3(50 { ` North South East West© CO NTRA�TO , " PHONE Size of rce �O Zone Classification IY�J! >( 4' ADDREEESSj ZIP Type Const. Occupancy Sprinklered I ❑Yes ON.❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP OWL Area Basement Area Garage Ar� Storage 7(0 2 506P CHANGE OF USE FROM TO Split Entry Split Level Rancher s. TYPE M" N W ALT. ❑ ❑ AD -N. RPL. MVE. ❑ ❑ No. Baths No. Floors No. Rooms Rec. Room 7, OF ❑ OTHER WORK BLD. ❑ PLMB. 1-1MECH: ❑ M.H. 11 POOL CERTIFICATE Req'd. Recd. Not Req'd. of EXEMPTION 8 VW d 7 / FEES COLLECTED L V ATION Sourice GAS Of EC RIC ATE SEWER 9, ` I (j V Utilities ' Single $ I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included .. D '� on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this —24-1 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 cal law regulating construction or the performance of construction. Plumbing �l'�'" DATE ei �/ SIGNATURE _ �� " -" Mech. SPECIAL APPROVALS SPEC I ONDITIONS: DEPT. REQ'D. RECD. ` tr7 Plan Check Env. Health /D ` `✓�� SEPA Planning Mobile Home Fire Marshall Other (Specify) Co. Engineer Utilities Zone Clearance SEPA Checklist J9I A4.6s Q k�-,. .0r-1 PERMIT NUMBER —F1 / 2-6 DATE a g 11-1Q 7C - TOTAL $ WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. �f" 1 41 1 R ' ',. 7 'f , 3� �p to I el oN J (9 /o 0, —.Ll g Me R ss t 131 0,17sle- 4� flo0 /? - /.?dd