1979, 09-11 Permit: 79-3772 Residence APPLICATION/PERMIT • PERMIT MBE477� 1
PLAN NUMBERe-
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` -21e 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 02 * * 107.50
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED * 1 0 7,5 0 tz
1. � OC ��
LOTBLOCK SUB (VISION I ,rL, //��L PARCEL NUMBER/S 7.--2-54-1---- , II 0 * 107.506
2. OWNERI 0'�I 4°a V 64' •" ,� /
E * Q00 C
3. 1 IN ��d1"I Ni 7L 7 377. 1
ADDRESS Required Set Backs in Feel.
1- 32 , -71147ZI North (south $ East 7 West 0 9— 1 1 —7 9
CONTRACTOR PHONE Size of Parcel I Zone Classifica ion
C4kN I .x, � 1 'q`�i I� . 6479.
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
N F--3 Oyes gNo ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
<i`a 000c3e2
5. ADDRESS ZIP DWL8Area I Basement Area Gag rea Storage
IS S 8 f Qi —'�-'
CHANGE OF USE FROM TO Split Entry Split Level (, Ranch
6. l
TYPE 14E)/)/
...���......______,,,,,,//////////// No,pathspNo. Floors No. Rooms Re Room
EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE, I j-, 1 l�
7. OF ❑ OTHER Req'd. Recd. Not Req'd.
WORK ai BV�• ❑ PLMB. ❑ MECH. CI M.H. ❑ POOL CERTIFICATE
of EXEMPTION ,x x
DESCRIBE WORK J Y i p v FEES COLLECTED
8. VALUATIet) i `t( G� Ie`/I -LEC WATER SEWER
9, 0of
Utilities -i-— Y / A �7" "o Single $ —
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included IQ7•I 0
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 co• uction or the
Plumbing
performance
of construction.
DATE
DATE " — 77 SIGNATURE f��� — Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. (✓ie,
G. t�, lyii,,Il c-,I� r. � tW Plan Check
Env.Health , ,y , 'C^-.L-e, — c o' I (- r' lii.i I'! b I 'lelii* cc
7/� CD
nr ✓n �Q ,,,/ SEPA CD
Planning IW I CNN IrTl�l 114 I o f o� Fr - U
11 w
a
Mobile Home co
—
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist C�/ /�/�` THCO�VIF�S A PF�RMIT. d O
DATE /�l) OFFICI• - .+ _ P1- .ciCC; i 1 `j' 3'77,2 Z *1 0 7,5 0 ° .-
APPROVED FOR ISS 'NCE —
Spokane County
A if
Planning Department
64,0";it ffrt/Pto
• 1 � Exemption Certificate
•
1 . WAS THIS PARCEL OF LAND SEGREGATED BEFORE MARC /13, 1978?
(exempt under section 3.3B5 of Short Plat Ordinance)
2. IS THIS PARCEL 10 ACRES OR LARGER ? YES NO
(exempt under section 3.3E of Short Plat Ordinance) •
3. WILL THIS PARCEL BE USED FOR A PUBLIC UTILITY FACILITY ? YES NO
(exempt under section 3.364 of Short Plat Ordinance)
4. IS THIS LAND TRANSFER TO ACCOMPLISH A MINOR BOUNDARY LINE
ADJUSTMENT, BUT NOT CREATING A NEW LOT OR CAUSING REMAINING
LOTS TO FALL BELOW MINIMUM ZONING STANDARDS OR AFFECTING
ROAD ACCESS TO ANY NEIGHBORING PARCELS ? YES 6:02,)
(exempt under section 3.3H of Short Plat Ordinance)
5. IS THIS PARCEL ZONED RESIDENTIAL OFFICE, LOCAL BUSINESS,
COMMERCIAL, FREEWAY COMMERCIAL, INDUSTRIAL OR MANUFACTURING ? YES NO r
(exempt under section 3.364 of Short Plat Ordinance)
4- J19
STREET ADDRESS FOR BUILDING PERMIT : 1-47/74./(—
I hereby certify the answers I have offered in connection with obtaining this
exemption are true.
Signature of Applicant:
ltiA/1411
ZONING: DATE: (c/2.-6/7,
1 . MP-1PPROVED BY: 2aryptide2ide,401.C�
' U
dfrot_ett,..41
"Mt ex.
5W '" a: , n HE Hu i,iN , N 1.'1 1t FFERSON STREET SPOKANE WASHINGTON 99260 PHONE 456.2205
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