1979, 10-26 Permit: 79-6780 Conversion BurnerNUMBER APPLICATION/PERMIT
PERMiT VMB
ILLAN
70�
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DATE V — I ✓ L 1
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
04+•
E
JOE ADyR
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LEGAL DESCRIPTION—SEE ATTACHED
1900
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Y
00 N
LOT
L
VB ISION
PARCEL NUMBER/S
2.
}9.006
E *DOC L
OWNER(
P 1i
3
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6779
ADDRESS
ZIP
Required Set Backs in Feet
North I
Sou[M1 EZone
1 0-26-79
CONTRACT R
PHONE
Size of cartel chow lsounst
f 6479
4.
ADDRESSn
ZIP
Typtourist.etourist.O
t. ccupancy,
SPr'mklered
^ _
P'
❑Ves ❑No ❑ Basic.
DESIGNER
PHONE
Valuation
Rui10'mg Area In Sq. Ft.
5.
—
ADDRESS
ZIP
OWL Area
Basement Area
Garage Abed
I Storage
CHANGE OF USE FROM
TO
SPIit Entry
Split Lear Ran ser
s. U t
TYPE I] NEW ALT. ❑ AD-N. ❑ RPL. ❑MVE.
No. Baths
No. Elders
No Rooms
Per, Rgnm
7, OF ,� EIOTHER
D BLD. ❑ Active.16AAECH. ElM.H. ❑ POOL
CERTIFICATE
I'd 1,
Rec'a,
Not Rep'tl.
WORK
of EXEMPTION
DESCRIBE WORK
E
n
lAy 1 f ✓
I•U
FEES COLLECTED
VALLAI ON 50wce GAB ELECTRIC WATER SEWER
9. utinuee
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 Taws and ordinances governing this
Building
type of work will be complied with whether specified herein or not. The granting of a per does not presume
give authority to violate or cancel the provisions of any other state or ocal law r Mating constructiop or the
performance of construction.
pe
Plumbing
Av1`rou NIS
DATE_O l� LC� SIGNATURE
0
Meet.
SPECIAL APPROVALS
SPECIAL CONOITI S:
DEPT. REO'm RECD.
f UO aM �Tu
Plan Check
Eno. Health
SERA
Pldnnmy
Mobile Home
Other Bpecifyl
Fire Marshall
Co. Engineer
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED
THIS BECOMESAPERMIT.
IN THIS SPACP,
SERA Checklist
DATE/*9
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