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1979, 11-16 Permit: 79-8010 Insert PLAN NUMBER APPLICATION/PERMIT ^,� PERMIT NUMBER I SPOKANE COUNTY — BUILDING CODES DEPARTMENT '.' �l g J �� NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESS i2 LEGAL DESCRIPTION — SEE ATTACHED * 7,0 0 n H1. OCKQ �. �PI�'I r � - o o,9 LOT BLOC SUBDIVISION PARCEL NUMBER/S 1,9 2. OWNER PHONE 1 1 — 1 6—7 p 3. `ra1R 10 /1 n ADD EELS ��'{yam f C �/,,� ��/� ZIP �� Required Set Backs in Feet a 4 7 7. 6F IQ 'r I Jr49F94IA,C� , North 'SouthEast (West TRA CONTOR PHONE Size of Parcel Zone Classification 4. ADDRESS ,I��vv�nlll ZIP Type Const. Occupancy Sprinklered ❑Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. 5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage — CHANGE OF USE FROM TO Split Entry Split Level Rancher 6. TYPE ,,_,� No. Baths No. Floors No. Rooms Rec. Room Lr/J NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7, OF ,_,.,/ ❑ OTHER - WORK ❑ BLD. ❑ PLMB. LK MECH: 1:1 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd. of EXEMPTION DESCRIBE WORK 8. ri K6r1 I i r I ceI (no-J ✓i�� 1 5") II 1 FEES COLLECTED VALUATION Sou GAS ELECTRIC WATER SEWER of 9. Utilities 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 co• ..n or the performance of construction. Plumbing DATE �� \ tP �� SIGNATUR I _ Al A.. .. /AA T 1 �� pO Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. Plan Check Env.Health SEPA O F— Planning U — w 2 Mobile Home co Fire Marshall Co. Engineer Other (Specify) Utilities TOTAL $ Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist / //// r THIS BECOMES A PERMIT. ( DATE l' /f4 O' ICIAL t' _ 1 1-116 -7 1 ; 1. U �' * /7 . 0 (0 _ ' .a,� A"'0 6 OR ISSUANCE