1979, 12-14 Permit: 79-9120 Residence, Renewal of M3177 f.fPLAN-NUMBER APPLICATION/PERMIT PERMIT N`U R
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE 14) /1 -Pi
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
02 * * 34,0,0
JOB ADDRESS
1. # / -'4 //We
jr�� LEGAL DESCRIPTION - SEE ATTACHED * 3 G,0,0 n
LOT BLOCK SUBDIVISION „ r PARCEL NUMBER/S 34 0i0v
2. '" 4,4, i° i /e4V-1
�-OWNER PHONE r- "� ! r E *O,0 O
3. h1LL 1tUiv.) li/ 7,� 5J C� ��/ "� � 91 1"9 G
�
ADDRESS ZIP Required Set Backs in Feet
8304/ t,• / `T`�'Zc') (',, \-) \ '2 I Cl 1 ; 1 2— 1 4—7.9
North South East West
CONTRACTORPHONE Size of Parcel Zone Classification
711 L L 1b U 1� V `7,2'( --,:y,5,'7,-; �`�I x \ s-(--)_ 4 6 4 7 9,
4. ADDRESS - ZIP Type Const. Occupancy Sprinklered
�a C>t{ E. I., ` {%r' n -, e,sC i,,,TIA ❑Yes No f� 0 Req'd.
d.
DESIGNER `y T� PHONE Valuation Building Area in Sq. Ft.
s. -.1-Nbos-,R k b AVT i 9a8- 7755 03(0% 0. _
ADDRESS ZIP DWL Area Basement Area Garage Area Storage
E. 1390:3 Sprat � , SuJ -/-o..s- 999/�a CdyC) uC, - K rr,,//'
CHANGE OF USE FROM JJ TO Split Entry Split Level 1 Rancher
6.
NoBaths No. loors Nqlooms Req Room
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. r `
7, OF 0 OTHER `
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRIBE WORK
8. r ,--_. ) FEES COLLECTED
VALUATION Source GAS Al ELECTRIC WATER SEWER
of
9. 10 6 V 0 Utilities �W\ \ t? . ,
T{
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 overnin thisBuilding ' `= 4,
"
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 r gi lating co struction or the
performance of construction. N— Plumbing
1
DATE 10- //' 7 9 SIGNATURE 4- Mech.
SPECIAL APPROVALS SPECIAL CONDITI'i NS:
DEPT. EQ'D. RECD. Plan Check
Env.Health /, _
j rx
Planninn "� —
U
2
Mobile Home va
Fire MarshallZ
Co. Engineer Other (Specify)
Utilities
TOTAL $ {"f Zone
—Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
�' { 1 '� n'-'''(,. ' ); *3 4, 0 0 2 172
DATI77, /f`; (°OFFICIA i 44-•":1,1-"A4. __ L — G I" / -+
APPROVED FOR ISSUANCE -
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