1979, 07-31 Permit: 79-1316 MH PLAN NUMBER ' PERMIT-NUR
R
j APPLICATION/PERMIT _` ..
SPOKANE COUNTY — BUILDING CODES DEPARTMENT �} I.2. l
i 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//--ADRESS
1. 4 LEGAL DESCRIPTION - SEE ATTACHED * 4 0 0 0 in
LOT I7BLOCK SUBDIVISION PARCEL NUMBER/S I45Cf7.� `�is . * (.0 0 0 v
2 Ipyy ER ��� �V PHONE / //` I A * O O 0 0
3. J ivit 2 ri K I Kli'r 9X'- 1 1 elt 1 3 1.5 2
ADDRESS ��--�r_T^/ �a�;,✓ l� ZIP Required Set Backs in Feet
/`�
t2. -ri9P. 11<i/V ( r, 79a) C' North 30 'South 8 ✓ East 45 'West I j 0 7-31 -7 9
CONTRACTOR. PHONE Siz7f,,,Pa l I F Zonepsific tion
wi -//y �t;''1IL' i 6.479.
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building 7Area in Sq. Ft.
5. ADDRESS ZIP DWL Area Basement Area Garage Area"A'�_" 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. ❑ MVE.
7, OF Cl OTHERt
WORK El BLD. ❑ PLMB. ❑ MECH: X.M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DES BE OR 8. N W 01'1,/lLj ( j4-lvG
FEES COLLECTED
VALU TIION/1 Source GAS ELE r TIC WATER SEWER
a IO ////0 of /r�` 1 I b I " C Y.L•1�1
V(/ Utilities C..�/,T-`�1� nl ✓I/f I v Single $
—
I hereby cirtify 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
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. _ 22(J� Plumbing
DATE 5/ 9 SIGNATURE ' '1 e"%'r-Mi Mech.
SPECIAL APPROVALS SPECT CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
EnealthQA�
``f�// -27: 117, SEPA Q
Planning
� U
41.0 a
Mobile Home
Fire Marshall �
Z
Co. Engineer Other(Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
1‘ •
SEPA Checklist / ") THIS BECOMES A PERMIT. z L j n 0' 0 0 0
DATE 7731/ 1'OFF t - ^—\---- Co---'---� 0 7 —3 1 —7 9 � > 1.U 2 * 4 U U t1
APP': : FOR ISSUANCE _
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