1979, 12-14 Permit: 79-9102 Residence, Renewal of M7086 PLAN NUMBER APPLICATION/PERMIT MBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 'PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /, —i 7 �9
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS 02 * * 8200
1. LEGAL DESCRIPTION — SEE ATTACHED 8 2 0 0
C LOT �BL�K JUBDIVISIO PARCEL NUMBER/S02,35;21.2_,3676/
2. /,.6T5 /—.2—.3 1_34Ky * 8 2 0 0
OWNER _3. ,G ,�-Gd e. N.,,,z„. 63S-F(��n.Z CA If Ai HOP, ADD PHONE E * 0 0 0
ADDRESS / // ZIP
Required Set Backs in Feet 9 1 0, 1 2
C i.&..2 A /.j TL, azd-e_ 9.9%.2.0‘, North (South East 'West
CONTRACTOR tC ^� `�� PHONE Size of Parcel Zone Classification 1 2— 1 4—7 9
4. �; R b,4 7 9.
ADDRESS ZIP Type Const. Occupancy Sprinklered
��( a...-' Dyes ❑Na ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. /8'6,3 —
ADDRESS ZIP DWL Area Basement Area Garage Area Storage
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. El MVE. 1 / rp -
7. OF 14 OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL���Z� CERTIFICATE Req'd. Rec'd. Not Req'd.
IC of EXEMPTION
8 XD SCRIBE WORK
p41.0. � �//G FEES COLLECTED
VALUATION Source LGAS ELECTRIC WATER SEWER
,�_� of
9. 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 Y2
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
DATE i -/-',1--79 SIGNATURE it _ iiii -. /.....00r-_-.- //. _ ' Mech.
SPECIAL APPROVALS SPECIA : ONDITIONS:
DEPT. REQ'D. REC'D. n _ D �/� -7 ! Plan Check
En Health /� /y{ _ ir/ '- / 6' 'tG
SEPA cc
Planning jt
.. /a U
"��LL„GGI�/`�< — w
a_
Mobile Home cn
Fire Marshall
Co. Engineer Other (Specify)
Utilities OU
TOTAL $ &Z
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist /Z> /hi- 772'Q / THIS BECOMES A�PE}RMIT. (�I p (;
DATE OFFICIAL 1L �� 4 - I 7 4 .L U.2 Z * U -, U n C f
APPROVED FOR ISSUANCE _