1979, 11-01 Permit: 79-7168 MH PLAN NUMBER APPLICATION/PERMIT [PE..MIT NUMBER 1
SPOKANE COUNTY — BUILDING CODES DEPARTMENT L B
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 ; * * 5 0.0 0
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED * 5 0.0 0 rn-
1. e /It 7..2.x' ,Z4-4 l�G ,t -�
LOT BLOCK SUBDIVISION- / PARCEL NUMBER/S -1=t—l8d/ 7 1 6,7 g
/
2. / NE�2 / 4 i P 4-6/.f „teVfcYif/. ata a 17PHONE hos 7/ B.i.-� /e 1 1 -0 1 -7 9
oyy ,3. 1)t-'i ,l./. 414.1�'-i4C./Li "( _ ../..c.35-3Z96 a f'/ZAG,00 -5'T. A PD z 6.4 7 9.
ADDRESS r ZIP Required Set Backs in Feet
.+L��.{,4� 4.; //i�a.e..i a,..A.Q' :.e!11(,_.0---ki(.4t.... t,,..._f�L, North�0 South �p..J East West /S
CO, TRAC OR 'j PHONE Size of Parcel Zone Classificat'on
,A - -e-----
AyDRESS ZIP Type Const. Occupancy Sprinklered
1a.✓ w _. ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
I
5. 4,00
ADDRESS ZIP DWL Area I Basement Area Garage Area l Storage
CHANGE OF USE FROM TO Split Entry ()Split L,v l Rancher
TYPE ❑ ❑ ❑ ❑ ❑ No)aths No. Floors No. Rooms Rec. Room
NEW ALT. AD'N. RPL. MVE. r'
7, OF ❑ OTHER '
WORK ClBLD. ElPLMB. ❑ MECH: ISl M.H. ElPOOL CERTIFICATE Req' Recd. Not Req'd.
of EXEMPTION
D�ES C R I B W O K
8. J4/ �J`'f�
di .,ot--wG3� •(�a-4_, l€ .L ,-� FEES COLLECTED
)IALI .7ATION 0 Source GAS ELECTRIC WATER SEWER
S%ZR ,'t,.1 of
9, ,n-e)4. -- 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 co struction or the
performance of construction. Plumbing
DATE/, 7 -- /% SIGNATURE S- IAA'44" .5)SZ Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
ele.eia i=/7///7 9 SEPA p
�/ I--
Pla> n9 ./ +:` 00 — w
V
Vy/ % / /�� Mobile •Home D
Fire Ilarshallo —
Co. Engineer Other (Specify)
QC-'
Utilities TOTAL $ 6'
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT. o C O O O a _J
DATE OFFICIAL
— i r-7.0 71 6. 8 z *.
APPROVED FOR ISSUANCE
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