1979, 10-29 Permit: 79-6948 ResidencePLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
0 PERMJ=JV
,,// L%E
DATE
02* *283.00
*283.00
*283.00Y
B *000
694,78
10-29-79
g 6479,
CHANGE OF USE FROM
TO
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
Split Entry
JOB ADDRESS
IAI / t) e Gid
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
ISUBUIVISIONI^I{�j
/�
PARCEL NUMBER/S kj�j< I Or 0+54 j._ q10,-1
�(s Iv "l/r`I r 7`T 7
2.
Kr
I
Y V (/rte ✓�
!` V� 1/" (
�/
Rec. Room
OWNER�� 10
7.
PHON D�
3.
Y/t-
WORK !L'�� BD. 1-113ElPLMB. MECH: M.H.
WORK
ADD ESS
p
Required Set Backs in Feet
North-7-6tl South U/ I East
Rec'd.
Not Req'd.
West
of EXEMPTION
CONTRACTOR ���� J '
J
PHONE �
'
7A766
Size o+ C 2�U Par�el✓I
U
Zone sification
I
4.
ADDRESS
CLI
ZIP
Type Const.
Occupancy
Sprinklered
AS
I
E
11/Ij/�✓
CG2
WATER,
�/T//1'nv,'I 'AvJ'I
SEWER
I,,V,��(/yl�l.
❑Yes ❑No ❑ Req'd.
DESIGNER
Utilities
PHONE
Valuali9n -70
Building Area in Sq. Ft.
5'
Single $
ADDRESS
ZIP
DWL/VAI ea
Basement Are
Garage Area
Storage
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
i,zov
IAO -) (LJ ,
5 72
0 PERMJ=JV
,,// L%E
DATE
02* *283.00
*283.00
*283.00Y
B *000
694,78
10-29-79
g 6479,
CHANGE OF USE FROM
TO
Split Entry
Sp It Level
anch r
6.
I
TYPE NEW 1-1 ALT. ElAD'N. 1:1 RPL.
1:1MVE.
No. Baths
No. Floors
No. Rooms
Rec. Room
7.
❑
Y/t-
WORK !L'�� BD. 1-113ElPLMB. MECH: M.H.
WORK
❑POOL
CERTIFICATE
Req'd.
Rec'd.
Not Req'd.
of EXEMPTION
DESCRI E WOR
8 / f
Hl ' /
VL
FEES COLLECTED
VALUATION
Source
AS
I
E
11/Ij/�✓
CG2
WATER,
�/T//1'nv,'I 'AvJ'I
SEWER
I,,V,��(/yl�l.
9.
Utilities
Single $
1 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�815'�
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
performance ocf, construction.
Plumbing
DATE/�/ /7 J
SIGNATURE
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT, REQ'D. RECD.
�K �G 2122 h/
Plan Check
Env. Health,
SEPA
Planning
��1 f G�
Mobile Home
Fire Marshall
Other (Specify)
Co. Engineer
Utilities
TOTAL $
Zone Clearance
6-%S l)ji
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist
uuii11 1
THISPFCOI4E� �E� MIT.
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