1979, 08-06 Permit: 79-1596 Move Residence PLAN MB i
. Jaz- APPLICATION/PERMIT PERMIT NUMBER I
7 �`zSPOKANE COUNTY — BUILDING CODES DEPARTMENT 79-/.5-9
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 0 2 * * 1000
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S ‘2_,2_,..51.1,/-,91",:r3 ; * 1 0.0 0
2. W b 370,', ,c,/0 94; .. ,' .A/ Z ,...,/, ,, f
OVER n PHONE /V/..y, et a3 AV 7-5i..ry c*7 /V2 RA) E. * l.'. 0 0 cam-`
ADDRESS ZIP Required Set Backs in Feet . 2 2 0
2 Z+J ri� LL � tIt9 2 0' North ,7 / 'South � " East v g 7/ 'West ,�` 0 7-0 9-7 9
CONTRACTOR PHONE Size of(,/rcelf, Zone Classification
4. ,GL--vka. s-6",,1 1 /2 G .r c .c.- -td . 2 6,4 7 9,
ADORES ZIP Type Const. Occupancy Sprinklered
./0-44/-e ❑Yes No ❑ Req'd. E * z
DESIGNER PHONE Valuation Building Area in Sq. Ft.
O A 1 *8 6 0 0 i
7
5. ADDRESS ZIP DWL Area Basement Area Garage Are
or L` 0 7-e0409 I I
16 I .2. 3 * 86006
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
X E *000 0
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. IK MVE. 1 5 9,5 k
7. OF ❑ OTHER -
WORK ❑ BLD. ❑ PLMB. ❑ MECH: El M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd. O 8-O L-7
of EXEMPTION X cJ V 9
DESCRIQE WOR ^ �t } // /;
✓�/Al _L:%J4%f�L= ' 1 C . /41 72z04:1/4v.-/-a.4404.6,t,,- 1':/: 7 :3.44 -L-L;"P FEES COLLECTED b 4 7 9,
LUATIO So rce GAS ELECT IC WATER / SEWER
9. 1,4 7/li 4- Utilities ,. u
ies �7,a,�. 3dJ_QI.C/ Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included , ' G,� -
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. 4:, .. Plumbing
DATE 7-1- 7 q SIGNATURECO -e>- ---: ,l
Mech.
SPECIAL APPROVALS SPECIAL C DITIONS: �
DEPT. REQ'D. REC'D. Plan Check i^ 1 /
Env.Health ,,i, (r�/ n y .Q-{.L..Q..�- 4-6-"C-at--OL. t!(--t., /"Y'7 / LJ
/ iii/Z h (6 , d/// ? l" SEPA / 0
O
Planning >I-a, CA 1%y -- l/ •J
Fire Marshall g3p..iJ_. Mobile Home
bo
Co. Engineer (� G Od0 Other (Specify) /d
uviis 1
SPca/A4 /Ns/'
Utilities i ���--.i
'G,
i- TOTAL $ 9
Zone Clearance
/ � /U �— / ,4J5px'C'T"Oit/ FES WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THISBCOMOE�S A PERMIT. i i 9, o U L n 0
d F
DATE OFFICIAL -
66 y 7 o * 0 U
APPROVED FOR ISSUANCE
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06,1111
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