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1979, 10-12 Permit: 79-5834 CarportUtilities Zone Clearance SEPA Checklist -7 % � /f1 �t /� DATE/�� /�- /'OFFICIAL. tkl2L?.�'.i�/� } L!l TOTAL sa3. on WHEN MACHINE VALIDATED THIS BECOMES A PERMIT. �,l' *25.00',,F' PLAN NUMBER APPLICATION/ PERMIT PERMIT NUIVE.sER SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 2 *2300 * 2 3. 0 0 x JOB ADDRES � R -I �i1 1�� v -- LEGAL DESCRIPTION -SEE ATTACHED LOT I BLOCK SUBDIVISION 40 PARCEL NUMBER/S Q75.5' •- JS?Z 2. �%a Oc SLK 4o E * 0 0 0 OWNER PHONE �� PSO/V /t ���r� >Q,1r�, t(�2 �fs�� [� W�.Ilksin 3. F 583.3s 1 0 - 1 2 - 7 Q /A�.QRE/SS ,ri 1S51z9lo /fvv ZIP '- Required Set Backs in Feet jQ North — South!/ East West CONTRACTOR PHONE Size of Parcel Zo a las ifi ation L� �vf1G 6N .�(-ZI3'3 i2 &+0 (moi! -P 6479. 4. ADDRESS Z P Type Const. Occupancy Sprinklered I5?; 13L -A 6 Tb ❑Yes XNo ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5' ADDRESS ZIP DWL Area Basement Area Garage Storage CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. No. Baths No. Floors No. Rooms Rec. Room 7, OF ❑ OTHER CERTIFICATE Req'd. Recd. jr,;Qt Req'd. WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑POOL of EXEMPTION (y\ DESCRIBE WORK- )4 /1 ®� �� 1 FEES COLLECTED VALUATION Source GAS ELECTRIC WATER SEWER of 9. 36-52c-> Utilities Single $ I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included All laws �3• ©0 on reverse side, and know the same to be true and correct. provisions of and ordinances governing this Building type of work will be complied with whether specified herein or not. Th ing of a permit does not presume to give authority to violate or cancel the provisions of any other st e r local aw regu ating construction or the Plumbing perform/ante of construction. DATE6 SIGNATUR _ Meth. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. RECD. Plan Check Env. Health SEPA C Planning L Li CL Fire Marshall Mobile Home Z Co. Engineer Other (Specify) Utilities Zone Clearance SEPA Checklist -7 % � /f1 �t /� DATE/�� /�- /'OFFICIAL. tkl2L?.�'.i�/� } L!l TOTAL sa3. on WHEN MACHINE VALIDATED THIS BECOMES A PERMIT. �,l' *25.00',,F' �D � L-1 / c v ( l /I !" / v 'k- /