1979, 10-04 Permit: 79-5251 MH PLAN NUMBER C.0-APPLICATION/PERMIT
APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT I9—,5".2,57
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /6 - 7q
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 Z * * 4 Q O 0
JOB ADDRESS �
1 ASQ �vf
l e, /0 Q Q.O. LEGAL DESCRIPTION - SEE ATTACHED * t1-000 v
LOT BLOCK SUBDIVISION ` PARCEL NUMB R/S
.34,t‘,.,� -o �<� 5 2 5.0
2. G e `-e/Jl3/i ,d---,AWv/1° Al -'7.:3 'i 7`"A'rt/e.i
OWN R�' I P o E i, 7 rte• 7-44;:f-- 10-04-79
3. � LO1 K) ��� 77
,..4.,,e--__s t- �t .5 iRA=TA7, ei 6 4 7 9,
ADDRESS /� �J/ j (� IP Required Set Becks in Feet`
Nd, I�-3D ca OC✓V1VV iCo North 7..3— (South/7 7/ East 6,/r / (West 8d f
CONTRACTOR„,, PHONE Size of Parcel Zone Classification
a. SikNW / CUA.e. Ceu.., .e
ADDRESS ZIP Type Const. Occupancy Sprinklered
)4 LA — ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Builng Ara in Sq. Ft.
5 ADDRESS ZIP DWL Area Basement
Basement Area Garage Area Storage
7-ZU — — —
CHANGE OF USE FROM TO Split Entry S Iit Level�/ Rancher
6. .444.{,&✓ .e-14,c:C,—
No. Baths No. Floors No. Rooms Rec. Room
TYPE NEW ❑ ALT. El AD'N. ❑ RPL. ❑ MVE.
7. OFCIOTHER -
WORK ❑ BLD. CIPLMB. ❑ MECH: I /M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. NODI ; i/s I40 I�1 V, �2 & d > FEES COLLECTED
VALUA-ION Vr/ J �r/Source GAS( ELECTRIC WATER SEWER
9. CI! 5o of
— Ail M UN1rl' 011
. 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
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
i 44.
AY---(----e 5'-'61---404-
DATE
I SIGNATURE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. 1 REQ'D. REC'D. Plan Check
Env.Health ( / ,,
Plannipairzei -
i
C / 6i'r /7q 4 440 I Q n-
` /— ?�• Mobile Home z-
Fire Marshall C
Co. Engineer Other(Specify)
Utilities D 6
TOTAL $ /71 6'
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES.A PERMIT.
DATE OFFICIAL 0 0 4 • 9 ` 5, 1n * 4U 0I
APPROVED FOR ISSUANCE
OFFICE OF THE
SPOKANE COUNTY PLANNING DEPARTMENT
Date almit, 3,0A ,19/1
Building Codes Department
n . Planning Department
Building_Permit _�_
The,plannina De artment has received a request from
for the release
of a building permit on the property as described on
the attachqd affidavit/legal description. It has been
determined'that a building permit should be issued
under the provisions of RCW 58.17.210. This memo
and attached affidavit/legal description must accom-
pany the building permit application.
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