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1979, 10-12 Permit: 79-5917 Barn j ti. 5 r. 'p I PLAN NUMBER R . - SPOKANE APPLICATION/PERMIT PERMIT NUMBER COUNTY — BUILDING CODES DEPARTMENT 74—.5.1/7 NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /!J /2 79 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 2 * * 3 2.5 0 JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED * 3 2 5 0 n 1. Z. f !a x'°,14//—rids LOT BLOCK SUBDIVISION PARCEL NU BER/S * 3 2 5 0 2. /` ez RT 6 ad V -4_a.- 4r Ana B *0.0 0 OWNER PHONE 6T,-V,JC/J ..Z 'TW.. • :fi x+'r` t�(,4 A/.(Y W, LA J 3. l:(.-.,rt-tt'te_, ,4' 9„'4,1-1---.9e7,3. Cid v..Cor . 4-uV. �,D rW 4,410,e10's.H.S. , 5 9 1.6 2 ADDRESS / /'��1! r(/1 / /ZIIPL7 Required Set Backs in Feet • / ] f .c{(. .�..-,' /Y:L�--Lf---1 _, ! ! .z5(y North Z, / (South 1 East �3-'� (West 'ti !v% 1 0` 1 G` 19 CONTRACTOR 'J/ PHONE Size of Parcel Zone Classification 2 6 4 7 9 4. .�- �� _. )t t/Ct�,�it.Ct ADT?RESS ZIP Type Const. Occupancy Sprinklered /h •C alta n— ❑Yes ❑No ❑ Req'd. DESIGNER PHONE Valuation Building Area in Sq. Ft. Fgl - 5. ADDRESS ZIP DWL Area 'Basement Area Garage Area I Storage CHANGE OF USE FROM TO Split Entry e, Split Level Rancher 6. b tet 'a -t:'o No. Baths No. Floors No. Rooms Rec. Room TYPE 17.nNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. - / 7. OF ❑ OTHER WORK ❑ BLD. ❑ PLMB. ❑ MECH: CIM.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd. of EXEMPTION DESCRIBE WORK 8. I/2 61- FEES COLLECTED VALUATION �j�J Source GAS ELECTRIC WATER SEWER 9t 4,0 O49-21" 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 JO S-79 SIGNATURE &AZ-1-6......-2.,. ..2.2 Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. Plan Check Env.Health Z, 4:1A:17' SEPACD oc~ .� w— c Planning 0_ Mobile Home cn Fire Marshall — Co. Engineer Other (Specify) Utilities ✓c) TOTAL $t-R, Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist �y -7 -1 0THIS BECOMES APERMIT. (� �7 7 (� DATE/ '2'l9FFICIALM/4414'.t.Te_./ 1 0.--1 2'-'7'9 5 7 1. l Z * 3 25,0 d I-, APPROVED FOR ISSUANCE - t } • • V / fr 7ivlit 0sono rdNavy gy Z-6 .>" ls/x a N..-?'n/5•1cV ?2/17/1S/k s i