1979, 07-25 Permit: 79-961 Residence, Renewal of M7130 PLAN NUMBER PERMIT NUMBER 1
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT — ‘,(c. I
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 2* * 4 6 7 5
* 4675 cn
JOB ADDRESS
6
1. —S.- 1910 �'� e-/r) 1'J0 _�h LEGAL DESCRIPTION - SEE ATTACHED%{�� * 4675
LOT BLOCK SUBDIVIS ON PARCEL NUMBER/S e-
/) ,..r r' ro c 7V 45• /�l �j kit/(5.. ,6/DG.1�.3, T''.i?�,m 0,7' /1/v.2,
OWNER �7 PHONE
g�d - la v 960k
AD KESS / ''' ZIP /� Required Set Backs in Feet 0 7—2 5—7 9
-77, ,5'94 /- 7/4.) - Y North 'South East 'West A 6479,
CffONTRACTOR PHONE} Size of Parcelgr� ZoneAClassification
4. �C.Z1I 4 A% da_/'/0'Q 7 1/7(2... '%�7 JO9c1 / / x 799' �✓ I`�%f�f f,
D�iRES /1 /.0 ZIP !� >l/ GType Const. Occupancy prinklered
V ` 13.10,< % �'rf�/ry' / 'Na i ❑Yes ❑No ❑ Req'd- A
DESIGNER / PHONE / Valuation Building Area in Sq. Ft.
5. I
ADDRESS ZIP DWL Area Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6. TYPE �, W ❑ ALT. ❑ AD'N. ❑ RPL. CIMVE. No.Baths No. floors No. Rooms Rec. Room
N 7
7. `i i `/ ❑ OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
` � , BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL
�� of EXEMPTION
Sc'IB WORK FEES COLLECTED
8. 4< �� I�b 1+41 l'
VALJA ION Source GAS ELECTRIC�JWATER SEWER
9, Utilities r!7 CidC 9..1,0 P.A.
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included 4-6,-7,
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not resume
to give authority to violate or cancel the provisions of any other state or local law regulating c nstruction o the
performan e o construction. Plumbing
DATE SIGNATURE ef7.��°�Y.k Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health 1/2, re/ tr1\rAii
l+-
Kai���L o
� i�Q SEPA
Planning1\11 'L
Mobile Home `o
Fire Marshall --
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
'
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist \ �`I� THIS OMS A P F�fMIT. 1 r c _:
DATE /19 OFFICIA -j ' L / '1 b, 1 -� * 46. 7 t1 !-
/ APPRO D 'OR ISSUANCE
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