1979, 08-31 Permit: 79-3294 Residence PLAN NUMBER PERMIT NUMBER
i 16/ APPLICATION/PERMIT 72- N2E a0,
% 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
02 * * 1 04,00
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED * 1 0 U.0 0
LOT BLOCK SUB !VISION _ Q PARCEL NUMBER/S pvR fi / _ G , * 1 0 4 0 0 v
2. 41 / vc/ . �, A-o7 <j ,C41-1(r 8
�41VE /� PHONE A *O,O C1 v
3. Q�� u�(�r -�.) .....
' f�,E,/til-1, '>t'K---D✓iJ 6'i3 3 2 9.3
ADDRESS 3 ZIP Required Set Backs in Feet J
P -7,.6---- () -6,x _4. , y1 ,2,t2.4-1,-1)4,4t- 79'/-d 6, North /1 ISouth�-J' East :341 lwest Fit i 0 8—31 —7 9
CO TRACTOR PHONE Size of Parcel Zone Classification
S
�' @ 6679,
4. �i Z - QcJ�l�ii�.�2 /fiv:�c
AD RESS ZIP Type Const. Occupancy tprinklered
,,L.^-vc.
Yes No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. .2.3/ —
ADDRESL'� ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.As No. Floors No. Rooms Rec. Room
TYPE 1 NEW ❑ ALT. ❑ AD'N. D RPL. ❑ MVE.
7. OF ❑ OTHER -
WORK IABLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION X
DESCRIBE WORTS,
8. /1&I FEES COLLECTED
'6!/� '.f�.&t:(-- -t-i-0 - i't/fL4-�'-- /1'V-(:-/E' . a ,,i,6i. _
ei ALUATION Source r GAS ELECTRIC WATER SEWER
of
J, ./' ‘,9'i 4JUtilities
of
Single $ —
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 Building /Lir
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 of construction. _ _ Plumbing
DATE 7 SIGNAT-LA E
---- - 17"-- . ) .
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health ,"' ) ,'
/,- 7 f- /.r_. SEPA CD
Planning — UJ
2_
Mobile Home co
Fire Marshall 7
Co. Engineer Other (Specify)
UtilitiesOC)
TOTAL $ `,d i Zone Clearance _
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist <-P/ iJ / THIS BECOMES A PE,I;iMIT. nn
iii-
//t; i' <— 'i } — l / '1 Q 1 .) * j O` , O 0.
DATE - OFFICIAL I
APPROVED FOR ISSUANCE —
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