1979, 12-11 Permit: 79-8922 Addition PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7g — 5,...22-
NORTH
, 2-
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
G2 * * 6200
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1.e� f4..;� O7 '/"� VW
} * 6 2 0 0 0
LO BLO K 5 IV SIGN PARCEL NUMBER/5 .3/ /�LL.—a7/3-
2. .6":4-/ii w-!--, ,G�jj�.iC l i f= PLAT it * 9 2.0 0 6
OW �R PHONE / o
'.y(({�V (C/�J��'r1 .- �.7 W,-6T- AA.R14S I RRiaA1-GT --RAc s E * 3 0.0 0 <�
3. ADDRESS-�� �� ��`�� � ��� �� Required Set Backs in Feet 8 9 2. 1 2
ZIP
�' / / '7/6,411 ,ly - .p4f2-4Jl,6 q9-Vii North south [East ., '�e' west iL� 1 2— 1 1 —7 9
ff,ONTRACTOR PHONE Size of ParFel , Zone Clascification
s NY, .4- - re:.et_(74--ia.. 9=24.A....��, .2/.41 k g76) 41-"Clait14. — 2 61 7 9,
4' �A�iDDRESS ���+t P j ZIP Type Const. Occupancy Sprinklered
//,. eA -7/1/ _01,d)" 5CJ ('.�.4d— `9.•2�e, Oyes ❑No ❑ Req'd.
DESIGNER `P ����� """" PHONE Valuationvv
ZIP DW
ADDRESS Building Area in Sq. Ft.
5. :2_/044/
�L Area I Basement Area Garage Area Storage —
" r
CHANGE OF USE FROM TO Split Entry Split Level • Rancher
No.Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ,)K AD'N. ❑ RPL. ❑ MVE. •--^ / /
�—
7. OF ❑ OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK ❑ BLD. ❑ PLMB. 0 MECH: LI M.H. 0 POOL
of EXEMPTION A
DESCRIBE'.WORK < FEES COLLECTED
8.(4 .� - 1,irr, '�. d c�,.�& ( I i4- . •C,-/--. -��%�(„�.�, `- � (-i)
V LUATION Source GAS ELECTRIC WATER SEWER
�K of
9. / Utilities
�i Single $ —
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included r GU
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building ,,,:"Z
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 /� u--"4/— 75 SIGNATURE y ' AF6444/1Mech.
SPECIAL APPROVALS SPECIAL COND�I•NS:
DEPT. REQ'D. REC'D. �t,.r � Plan Check
Env.Health + "L"-��' �r
J �p iya I/ 7 SEPA
I—
Planning v
_ w
Mobile Home cr)
Z
Fire Marshall _"
Co. Engineer Other (Specify)
Utilities r De�
TOTAL $ L>
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist .,/,
% THIS BECOMES A PERMIT.
I
DATE 4/ �I : ✓ 12 — l 1i i
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