1979, 10-22 Permit: 79-6442 Remodel PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT Itl'�
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES —`PRESS HARD TO MAKE 4 COPIES 02 * * 25.00
JOB ADDRESS
23 ��
Mfz-
LOT BLOCK LEGAL DESCRIPTION — SEE ATTACHED * 2500
1 SUBDIVISION PARCEL NUMBER/S * 2S 0 0 8
/253/-- 2Zo.3
2. Prof etLC.K ISS ci- 13Loc-iC 224 ELY /0' oP E * 0.00
OWNER PHONE PLOCK 155 /NC L 2.1 STI2.Ip E OF 4 At )
3. DP'L-LA ES L.161,L q7k, —2.2.5-63ALL RLoc C 224 LE..as >awy d- ADS 32,S' MD Ex- 6 3 1,6
ADDRESS ZIP Required Set Backs in Feet ��//
g. 732 3 12,1A-i- PA2- SPOIGAAJ� Yg2(6 North F !South ,J\ East (west 1 0— 1 8—7 9
CONTRACTOR PHONE Size of Parcel I Zone CI ssification f 6 4 7 9.
4. <S. 'X'/00` 11"14`1, 11. g.icat.'cii12P�- S'iI,BADDRESS ZIP Type Const. Occupancy Sprinklered
V-N 123 ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
115.00 r /70
5. ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage
i--7O
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6. --------
,�,/ No. Baths No. Floors No. Rooms Rec. Room
TYPE Ili NEW L`.? ALT. I=1 AD'N. ❑ RPL. CI MVE. �— "—.....___
7. OFD OTHER
WORK BLD. El PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION 2------
DESCRIBE WORK NE .3 6A0iNETS. INSR2
IpE. mi ► EmoDcL_ FEES COLLECTED
P
8. INs-rikLi_A-n ort of O '/ WALL— &iv.u, FL. OP- iN 13N-r1-1 4 oe3M MMD NEW stiMUER_
VALUATION Source ) GAS ELECTRIC WATER SEWER
9. '�/SoC�" , �Util
Utilities .)(i -n1 Single $
—
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
c.
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building 4Z5 JR f
type of work will be complied with whether specified herein or n . The granting of a permit does not presume
to give authority to violate or cancel the provisions of any othe stat or local law regulating construction or the
performanceJofconstruction. �G Plumbing
DATE/ /2-v- 7 SIGNATURE) / t/►^� L ' Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: nc
DEPT. REQ'D. 7 REC'D. GoNS"/721dG'TIDN BECaLi ( BF.�RIO. OBTA/NIN6 Plan Check
Env. Health l f/ z7 y P rArr
�l _j I �L a, t'1'7-(-2) /"GAIL f I M I r SEPA o
Planning — v w
0-
Mobile
Mobile Home
Fire Marshall z
Co. Engineer thMeci 'y)
Utilities TOTAL $ 2�-Xl(
Zone Clearance
.- M WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist V,, ��"/�,/ � THIS 1BECOMES A PERMIT. L l d * 5.0 �, F
DATER:). lb OFFICIAL ` 30 "�.A. 1 0 —'2 2 7 9 6 4 4.2 a.
APPROVED FOR ISSUANCE —