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1979, 09-20 Permit: 79-4342 Residence PLAN NU ER APPLICATION/PERMIT PERMIT NUMBER //////C//JJ�Z SPOKANE COUNTY — BUILDING CODES DEPARTMENT 17— 1,/`" 51Z NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE y-42-e) -7� APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES JOB ADDRESSp 0 2 * * 21 1,0 0 1. '7.5zOa e yzlcLam. LEGAL DESCRIPTION — SEE ATTACHED th- LOT BLOCK SUBDIVISION PARCEL NUMBER/S * 21 1.O O 2. �` e5 W 2 .Pu i' 7I IL ADD It(°A _ 7 * 21 1.00 OWNER PHONE .; 'i 5 -3 4 — O5 Of 4E21W:4a 3. vii 1 k t- 'TEgi-t A6tz-- 4Y7 0•3 e2. E *0,0 0 ADDRESS ZIP Required Set Backs in Feet 4 3 4/, 1 2 Nt.. 2'623 Likeek' 99aC7 3 North b 'South 710 -0[East IWest 1i 9 n CONTRACTOR PHONE Size of Parcel Zone Classification 0 7 9 -2 0- m1cHAEL_ 3f1rneS CdniS'f �IA4 lot,y 140 y 5 ' �-6e-lc /5u13U iS 6479. 4' ADDRESS ZIPType Const. Occupancy Sprinklered ^ (04114 5'i Ai 1 O /U 9 Zr e, .v4 E3 CI Yes ENo ❑ Req'd. DESIGNER �_ PHO ValpionT, % Building Area Sq.��t ; 5. ADDRESS ZIP /yDWCCLL//oe�)f,Area .NBase ej Garage Area Storage _ TIL `4, of--i/(�) — CHANGE OF USE FROM TO Split Entry plit evel Rancher 6. --- - FR:4's No. Baths No. Fs No. Rooms Rec. Room TYPE 2/NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. L y.� 1� 7. OF _, ❑ OTHER 1 - { IJ/v/ WORK BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICAT Req d. Rec'd. Not Req'd. of EXEMPTION X DESCRIBE 8iORK 8. 14.E ) 5ihlbL-E F:NyhhLY k'ESiDEACE. FEES COLLECTED VALUATION Source GAS ELECTRIC /��yTEeWATER SEWER 9. 42, 95 of ---utilities �a33 WR 'IISTEON SEPI IC' Single $ I hereby certify that I have read and examined this application and have read the "NOTICE" provisions includedk) — on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building ,0/f/ type of work will be complied with whether specified herein or not. The granting,of a permit does not ume to give authority to violate or cancel the provisions of any other state or ocpl la ,re Ulating constr on or the performance of construction. j t Plumbing DATE <:,'—' 7— 7 f SIGNATURE? I J teV 4 Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: DEPT. REQ'D. REC'D. Plan Check Env.Health �/ 0(1_,At 0,-/._ � � I l � ✓i SEPA cc I— Planning W — 2 Mobile Home ul Fire Marshall Co. Engineer Other (Specify) Utilities (� TOTAL $ cZ/l Zone Clearance WHEN MACHINE VALIDATED IN THIS SPACE, SEPA Checklist /// J �t� _ BECOMES A PERMIT. / THIS ,1 DATE 1 OFFICIANL: �� 0 9--..,2 [1 r_7 (1 4 3 4, 2 2 *2 1�.L 0 0 2 r2 APPROVED FOR ISSIhCE U 7 00 50 00 O tV Ne„ tof.0it, „se N. 12 1 2 N o 5 - I000 GALS 51 ,-t0 X 22 SLAB I •0 t 33 ! 0 .V' EXP JOINTS N Oh N k . ____.F.F 5.3 1 I .O LOT 7 BLOCK B w,,,, .,.... ,_. WOOD LAWN I s s I "' PARK 0,0 if 0.0 ADDITION tY 9 T H — 0,0 00 • r a