1979, 08-03 Permit: 79-1548 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
1.
2.
3.
4.
JOB ADDRESS
l&10 �, ' 4-ik1 KOACO
LQT
OWNERny/ P E 92.
ADDRESS OX IIL�si
�—r 1 13C7>(
`7° 5 ,T/ I
CONRACTOJt
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
SUBDIVISION j
'f+ 14-1 LIQ✓ 1�F•I,
PH
N E 74
PARCEL NUMBER/5
29 4-I - oo o I
Z8353 5
Required Set Backs in Feet
1SouthW
North
East 50 (West
PHONE
Size of Parcel
Imo.
K7-06'. II
ADDRESS
ZIP
Type Const.
Occupancy
Zone Classification
'a`11 N,G
Sprinklered
DYes ❑No ❑ Req'd.
DESIGNER
5. ADDRESS
PHONE
Valuation
Building Area in Sq. Ft.
I560
ZIP
DWL Area I Basement Area ( Garage Area
Storage
6.
CHANGE OF USE FROM
L7 NEW ❑ ALT.
❑ BLD. ❑ PLMB.
TYPE
7. OF
WORK
TO
Split Entry
Split Level
Rancher
❑ AD N.
❑ MECH.
❑ /Ryp L. 0 MVE.
LJ M.H,
0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
8.
DESI ORK O6qirLM
L�
VA
9.
_UATION
II ,
Source
of
Utilities
GAS
ELECTRIC
1—
WII R
SEWE
C
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 stat or local law reg ng construction or the
Performa .f construction.
DATE
SIGNA
DE T.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health
Planning
(id,6 7/27f 7'7
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE3/-/ 7OFFICIAL4Q/A:4,
FEES COLLECTED
Single $ /�
Building 7' I ,0O
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
do
TOTAL $
PERMIT NUMBER
DATE
07* *74,00
*74,00
8 id
E *Q00
139,5A
08-01-79
6479.
07* *74,00
*74,00
*74.006
E *000
154.72
08-03-79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
08-03.-79 15485
*740.0 a.
t
f 2 c7 oI I
C X-17,)
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+11491