1979, 08-01 Permit: 79-1425 Barn"r
NUMBER APPLICATION/PERMIT PERMIT NUMBER I
4 SPOKANE COUNTY — BUILDING CODES DEPARTMENT -7, -Cc1-2,S
' NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE Ni UL Z7, iq7y
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 2 * 2 0,0 0
OB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED * 2 Q 0 0
165
1. l8 5o��2n�aA7d
LOT BLOCK SUB IVISION PARCEL NUMBER/S p-rN 2.5
DF 353 -'fOrY3 * 20,00
2. 5 3 roit.d erare,. .z-rt add.d%eAi B * 0.00
OWNER PHONE
3. 64nbf Q-A 1 1 7,7 2
ADDRE ZIP Required Set Backs in Feet ��j n
S\� Z North I8�'ISouth Ease ✓ (West 0 7-2 7-7 9
C NTRACTOR
PHONE Size of Parcel Zone Classification 2 6 4 7 9.
4.
ktid c'✓t thz4id I,,,r1" ',1,.2-6379- 1 Acl21- A PRoy. AcR lcUL-c ngAL- SUB
ADDRESS , {(.�( I $ ZIP / Type Const. OOccupancy Sprinklered
,�`/ 0 k 0vOL/AUb�U ff Q b o-iv '•�-' El Yes ONO ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. Sz.m t— gZ OD0 o S1UO _
ADDRESS ZIP DWL Area "I Basement Area Garage Area Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No.Baths No. Floors No. Rooms Rec. Room
TYPE It NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. r
7. OF ❑ OTHER VON / / �r7rN
WORK ❑ BLD. 0 PLMB. ❑ MECH: El M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
1.
of EXEMPTION li
DESCRIB WORK
8N FEES COLLECTED
VALUATI N Source GAS ELECTRIC WATER SEWER
9. 2000 w1
= of
, Utilities �x��T/Iv 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 2'0
.0
0
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 la?w reg • g construction or the
performance of construction. Plumbing
!�1 t,(,
DATE ? v`� -7 7. SIGNATU' I�� 4.14/7/11,reCI
Mech.
SPECIAL APPROVALS SPECI'L CONDITIONS:
DEPT. yREQ'D. REC'D. -•—,g .A.0 ate. V�Sl Plan Check
Env. Health
/7, 7
-- 4- 77 2 741/7V, G//(1— z'6-761CLE Pr SEPAcD
I—
Planning _
U
µ4!L1-0 I.[) .� I w
0
Mobile Home
Fire Marshall GOT,
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist • 1, r THIS BECOMES A�PERMIT.
DATEv/r1��DFFICI! ------sr-� �- 08 -01 -/ 9 142. 52 * 20. 002x2
APPROVED 2R ISSUANCE _
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