1979, 07-31 Permit: 79-1318 MH PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 3l
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 7 * * 4 0 0 0
JOB ADDRESS ) * 4 O. O O
1 E i - 3 o 6, Cere'e. LEGAL DESCRIPTION - SEE ATTACHED
rn-
LOT BLOC SUBDIVISION „+ /� f� }�� PARCEL NUMBER/S /955 ,...,/qr, * �'0.0 0 6
2. /5-. if [i f e2-4..v& &f' C� A=9-- a7 A * 0.0 0 8
,I' _R PHONE
,� �j 131,78
3. AP i RESS`�� ZIP U Required Set Backs in Feet
5v: L/r 7 -44y{ /'fit/ ,/ i!�b l,I,.J -15'8°'Cj North 30 ISouthv'J East 10 'West 5 07-31 -79
CONTRACTOR PHONE Size of Parcel Zone Classifica io 2 6 4 7 9
(.30 x r70 - l' i-.
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
Dyes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building A((rpee�a+Sq. Ft. _
5. ADDRESS ZIP DWL Area Basement Area Garage AAr'Ea Storage
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE X NEW ❑ ALT. 0 AD'N. ❑ RPL. 0 MVE.
7, OF 0 OTHER Req'd. Recd. Not Req'd.
WORK ❑ BLD. 0 PLMB. ❑ MECH: M.H.X ❑ POOL CERTIFICATE
-of EXEMPTION
DESCRIBE WOR COLLECTED
VALUATION Source GAS ELECTRIC WATER SEWER
j etc/ of /� C � yy�
9. /ei�e6 Utilities 1. j,b f? TG't"rri/4.' Single $
—
I hereby certify that I have read and examined this application and have read the "NOTICE" proAisions 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 construction or the
performance of construction.
2.1 Plumbing
DATE ,,7 SIGNATU3'r 1' "``—h,—, Mech.
SPECIAL APPROVALS SPECTDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Healt � V t �
c r --77- i7791-
SEPA cccc
Planning U
.Q w
w
Mobile Home V)
Fire Marshall z—
Co. Engineer Other(Specify)
Utilities t
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
SEPA Checklist �] �� , O '7 _1 'I �7 (� R p * /� ? (� I, „
6 � OFFICI� I 1 / 7 i 5 1, " z 4 0, J 0 Q. F- -
DATE
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APP'IV 0 OR ISSUANCE
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