1979, 10-31 Permit: 79-7051 Damper PLAN NUMBER APPLICATION/PERMITQ PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT �C/ 71- -7,9 (
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 4 * *7.0 0 N
JOB ADDRESS * 7,0 0
1. S 3ySc.
La, ,444 7e 1k LEGAL DEQCRIPTION — SEE ATTACHED
LOT BLOCKSUBDIVISION PARCEL NUMBER/S *7,0 0 v
2. B *Q00
OWNER PHONE
3. 1-ecr Pa
/4 zi4/e 5#Air -/3yo, 70508
ADDRESS / / ZIP Required `3 Required Set Backs in Feet
6 t
5 3 VA '(?i1/ / a4ie' ,)ff4 ,e, et9-- ,72c..)' / ' North 'South East 'West 1 0- 1 -7 9
CO,JTRACTOR / Y PHONE Size of Parcel Zone Classification g 6.4 7 9.
- ADDRESS-7 ! �i a ZIPType Const. Occupancy Sprinklered
f7/01 ✓/v /we/{!,i is ,�!��E,;<� e . Ls. ' 9.9v"1/ ❑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.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW D ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION _
DESCRIBE WORK L fl ,.._ z FEES COLLECTED
8. /4.5 fa / 5 .5,2.sip' r r 4(41., r it,
VALUATION Source GAS i/ 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 construction or the
performance of construction. Plumbing
DATE Al _ 2/ SIGNATURE d/ .,-+ is "a
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: 4."'".'-t vU
DEPT. REQ'D. REC'D. __ ii /' PIa Check
-5er6,e Cgee-7 ,�07.- e"s(
Env.Health 3
SEPA o
U
Planning — Leu
a_
Mobile Home cn
Fire Marshall Z
Co. Engineer Other (Specify)
Utilities
TOTAL $ 9i Oe
Zone Clearance
- WHEN MACHINE VALIDATED IN THIS SPACE, 7 C
SEPA Checklist THIS BECOMES A PERMIT. ;} - o * I,(J 0 e-I-
DATE7 I ' OFFICI• I� � �, 1 r'?
APPRO�D FOR ISSUANCE —