1979, 10-15 Permit: 79-6019 Residence PLAN NUMBER APPLICATION/PERMIT i PERMIT NUMBER I
P-.> 47"‘ SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7c' `o0/'J
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /a °'6- 71
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES u 2 * * 2 3 3 0 0
1 SLJOBADDRESS /6.4.-/ l/�� LEGAL DESCRIPTION - SEE ATTACHED *2 3 3.0 0 N
OT/1:-',2BLOCKY SUBION PARCEL NUMBER/S * 2 3 3 0 0 6
2. / 410 , 4426 .,r[v4e-AL-- ,/,-.o77 /3 k QE *0 0 0 8
OWNER 9L�Yn PHONE
3. A-71
ESS 2�' , ` A-'1't`d4�f 9R.,?—& 5)•S )4L)L itl AJP ADD TO 6.R,'.6-NA,CRE-s 6 0 1.8 2
Zip Required Set Backs in Feet
-� n A '
./..:LA.{f.L3 7 ! �jl��l-j!_/i'f�L�W '�i���� k�L�(' `0� '�"ld North �;f.� ISouth �r�� "East �..,, 'West :5 1 0- 1 5 i-7 9
CONTRACTOR PHONE Size of Parcel r s IZone Classification
4A i aIt
. .i.piec , i 647,9.
4- AD RESS ZIP Type Const. Occupancy prinklered
ki'� ❑Yes gNo ❑ Req'd.
DESIGNER PHONE Valuation 4/0 Building Area in Sq. Ft.
,.7',e,-/
_
5.
ADDRESS ZIP DWL Area I Basement Area Garage rea 1 Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. atB hs No. Floors No. Rooms Rec. Room
TYPE KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER Q _ ,"`F
WORK
❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTIONX.
DESCRIBE K BE WO / FEES COLLECTED
8. ,�ci-�,C t � � '."
VALU TION Source AS ELECTRIC WATER SEWER
fGg^ of
9, ` . 5-J Z.) 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 .<,`3. "
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
Plumbing
performance of construction. >
•
DATE/c)'CC-- 2' SIGNATURE ���' * �� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REC'D. REC'D. Plan Check
Env. Health /D f f NO f}MR
.5 k.LE
CY
/_ CAL C . — fit -
Planning —
NEED MenDen REDO 0
G Mobile Home N
Fire Marshall —
Co. Engineer Other (Specify)
Utilities ��jj �
TOTAL $ 04�`
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Cheeclist / / THIS BECOMES A PERMIT. (} (�
OA//-44, DATE `nt ' OFFICIAL\ Q/� / 1 0 .1 54-7'9 6 0 1. 7 z * 2 3 3,0,0 2
APPROVED FOR ISS CE -
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