1979, 09-24 Permit: 79-4563 Addition PLAN NUMBER-- APPLICATION/PERMIT PERMIT NUMBER i
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 2 * * 1 0 0 0
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED * 1 0 0 0 ro
1. l75l5 E, -r-14 />:Uk. Q
LOT BLOCK SU DIVISION PARCEL NUMBER/S !5-S2 1301 * 1 Q 0 0 6
2. 9 z APPLE VALLr y 9 ST I S-T ADD. B *0 0 0
OWNER PHONE
3. CHAR.LES M. 5TEkR...1-rr `l3EN-3951, 1 069k
G� ADDRESS rd ZIP
RequiredSetBacks in Feet I �2
-! 23 co LUL Ai 11_ 4N FRE-EU/ 'l Gam, orzEG l7,96 7 North /'�� 'South East 1,4 (West ac✓ 0 7—2 6—7 9
CONTRACTOR / / PHONE Size of Parcel Zone Classification 140 2 6 4 7 9.
4. SA-M e- 7e X /2.,o' R€SfPENmAz mos ILL
ADDRESS ZIP Type Const. Occupancy Sprinklered
Vid IZ-3 ❑Yes ❑No D Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. /40
ADDRESS ZIP DWL Area I Basement Area Garage Area I Storage _
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
,-/, ,_,/ No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW LI ALT. C rN. 0 RPL. 0 MVE. -- I 1
7. OF ���/^' ❑ OTHER
WORK 0 BLD. 0 PLMB. 0 MECH: 1!`TM.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION 1,----°'
DESCRIBE WORK "
8. 4fDfl7O J of• A STOgAGE gr,DM -r0 EX/ -rIIYC MOBILE HoME FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
9. 41 500 Utilities EXlSTINg 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 10'00
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 stater local law regulating construction or the
performance of construction. Plumbing
i 1
P / f
DATE _ �4I SIGNAT R .c......, ✓ ./✓ . ..LL, i! Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health Jr , -w
C C et '4'‘,-,-: ;,', 7/_,i)c, ';,)/ Q'/ SEPA --
Planning — ,,"
n_
Mobile Home
Fire Marshall y
Co. Engineer Other(Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS CO A gErRMIT. Y 5
U,
3 z * 1
0, 0 nn
a
DATE11-4179 OFFICIA
APPRO OR ISSUANCE _
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1-01
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