1979, 10-01 Permit: 79-5059 Addition PLAN NUMBER1 APPLICATION/PERMIT PERMIT iV N7 VI✓IGEr(
SPOKANE COUNTY — BUILDING CODES DEPARTMENT f - 909
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 0 2* * 1 1 6.50
LEGAL DESCRIPTION - SEE ATTACHED
1. / 2/ QU C_, 11-7,-it1,-i-e- * 1 1 6.50 to-
LOT BLOCK SDI0 PARCEL NUMBER/S l '/"'C1�C1'f
2. s / 14` ,h.-0 7—(!_/
,6,4_1(.-7.k" * 1 1 by 5 0 V
OWNER PHONEn O O
'1/' e�.��T�K t 42111$ 2J5' alned/A/ A1D/ TG rt.- RE ' E * U
ADDRESS ZIP Required Set Backs in Feet , 5 O 5 8
s �� �// !/ i
s '4 � l.__j "f- '��-zL' ,�?�/& North ISouth 5 , East 'West ;‘,25
-
CONTRACTOR PHONE Size of Parcel Zone Classification 1 0—0 1 —7 9
4. �.', 2eC(Vr crt< 1.4 1 g 6 4 7 9.
AD9RESS ZIP Type Const. Occupancy Sprinklered
. �/ti-, ❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
,� ,/i5 ,
5' ADDRESS ZIP DWL AreaI I Basement Area Garage Area I Storage
a:f it 49
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. �i
7, OF ❑ OTHER i "'�
WORK ❑ BLD. ❑ PLMB. LIMECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION x
DESCRIBE WORK "
8 FEES COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
0Oof
9. gan®---. Utilities —
/ Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included /1'6
�/`�
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building �I
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
/ e/
DATE t'!-27-- {f� SIGNATURE 1./4 % �/�_-,--� 1s—,sr Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: V
DEPT. REQ'D. REC'D.
Plan Check
Env.Health )I/ �o, /j en.i,
gA-it � /77-*?`7177
SEPA O
Planning L /rte✓ �i _ a
,�// Mobile Home `,
Fire Marshall a Z
Co. Engineer i Other (Specify)
Utilities .:5"-
TOTAL $ ///
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /'/7IOFFI
• .�_ THISiuCOr1EI, REMIT. 5 0 5, 9 z *'1'16 5.Oa. �
DATED •-`�' ,JJ jj / ,
APP''I -i FOR ISSUANCE
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