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1979, 09-18 Permit: 79-4170 ResidenceI PLAN 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 JOB AD RESS Size of Parcel Zone C as ' 'cation S /l2 q LEGAL DESCRIPTION - SEE ATTACHED T 2. BLOCK SUB IVISION � 6.4 7 9. tADI). ZIP PARCEL NUMBER/S o �� 7 r 7 —3 0 D / 13sPiNE 3. O eyfU rVQ PHONE ADDRESS f/ - ZIP I{/, / (Y Required SetBacks in Feet North 0-6Required C/ t ( East West 3,5 PERMIT NUMBER DATE 02* *74.00 *7 !. i G 0 Ir *74,00 a*a.c,. 41 699- 09-18-79 CONTRACTOR PHONE Size of Parcel Zone C as ' 'cation S /l2 q D 6 t, A), U-11 6.4 7 9. 4. ADDRESS ZIP Type C nst. OccalYancy Sprinklered ` - ❑Yes o ❑ Req'd. DESIGNER PHONE Valuation UU Building rea in Sq. Ft., 5. 56 / ADDRESS ZIP D/W�Lgre Y C Base Area Garage Area �(O St�p/�g) / Il✓ CHANGE OF USE FROM TO Split y Split Level Rancher 6. TYPE KNEW 1:1ALT. L1AD'N. 1-1 RPL. ElMVE. No aths sa No. Floors No. Rooms Rec. Room 7, OF ❑ OTHER CERTIFICATE Req d. Recd. Not Req'd. q BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑POOL WORK of EXEMPTION I S SCRBE ORK I FEES COLLECTED 8. � ' a-YYI �' VALUATION Source GAS n0 ELECT C WATE SEWER �— 9. 1 Utilities /I, Isof tL (�©0" e ' Single $ _ "NOTICE" I hereby certify that I have read and examined this application and have read the provisions included 41- 00 on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building —FJ-ty 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 2� SIGNATUR Mech. SPECIAL APPROVALS SPECT CONDITIONS: DEPT. REQ'D. RECD.jj�y" % �� �� Plan Check Env. Health ,� V G 1�� ��J t ! ��6L W (� Planning ,, /� ft G f A tv SEPA � C Mobile Home Fire Marshall ✓ _ Co. Engineer Other (Specify) Utilities TOTAL $ Zone Clearance IN THIS SPACE„ WHEN MACHINE VALIDATED SEPA Checklist �., ;% THIS B M �S'� 417,���� *74.�0� Crt_� f]ATE �� (7FFI C.I A1\`_ L 07 8, SLK l mlcf�1 FAIR,< AaDN , STS�AN Co,) wA,, SCALE ; { "= 20