1980, 02-14 Permit: 80-1180 MH PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER 1
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE —/ U
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
02 * * 1000 C
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED i 0 C: 0 C
1. e /57 ..3 `v i2 i �`�j�`�J'/` ,
LOT BLOCK SUBDIVISION 1�^ I PARCEL NUMBER/S PORT—/c3O 3 —CV.Z.3 1 0 0, 0 0
2. 5E,E it rrkCHR-b L.ECzAL. PARCEL * 0 �,
pyo/ ER t PHONE i1 J i.
3.a/,/1 .Gl_,N�� p[„ .JtCJ%.u-d-Gti,[J�.� R�-3�53� 1 1 7.9 E.
ADDRESS ZIP Required Set Backs in Feet
C , /57/. 1),all..;t tf � 99'37 North. $ " ISouthS" East399l-' (West .2 1 0 2— 1 4 —u' 0
CONTRACTOR / PHONE Size of Parcel Zone Classification
Seir.444.E /7. 'x /7/,4PP ag 6 4 7 9,
4' A DRESS ZIP Type Const. Occupancy Sprinklered
..-414,1A-1----
-� ❑Yes ❑No El Req'd.
DESIGNER� PHONE Valuation Building Area in,Sq. Ft.
�44195. /ADDRESS ZIP DWL Area I Basement Area Garage Area Storage
/47-d/
CHANGE OF USE FROM TO Split Entry Ality-6-244...0,vel Rancher
6. ����� •1 T
No. Baths No. Floors No. Rooms Rec. Room
TYPE
XNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. /
7, OF ❑ OTHER CERTIFICATE Req'd. Recd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. ❑ MECH: M.H. CI POOL y�
of EXEMPTION '\
DESCRIB WORK
8. L �Q� FEES COLLECTED
VALUIT A. ON DD Source GAS ELECTRIC WATER SEWER
''7l�
9, 6_Q(�O'` of
Utilities Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included /j
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building /e','
type of work will be complied with whether specified herein or not. The gra ting of a per it does not presume
to give authority to violate or cancel the provisions of any other state or s O law regu ins a1. • ruction or the Plumbing
performance of construction.
DATE e2 -4'Yo SIGNATUR' /./`/ 'A iG�� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. EQ'D. REC'D. Plan Check
Env. Health I-
/ C) SEPA
Planning —
Mobile Home n
Fire Marshall _
Co. Engineer Other (Specify)
Utilities
TOTAL $ /DO
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist —/171— ?'
'YJ' o THIS B GO E AOE(RMIT.
U 1 _ U L1 & tz * i 0 U.
Ia1
DATE OFFICIAL-R/7/4,,C2,21. --
\,� J —
APPROVED FOR ISSUANCE —
OFFICE OF THE
SPOKANE COUNTY PLANNING DEPARTMENT
Doteld --- ,1910
0 _ Building Codes Departmen
rom Planning Department
mbject Building_ Permit F/LE �/ �/�/�o -7 9_ _-_
The Plani
iing Department has received a request from
for the release
of a building permit on the property as described on
the attach d 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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