1979, 10-25 Permit: 79-6668 Residence PLAN NUMBER # I APPLICATION/PERMIT 59-
MIT I. 'R?FAER
3 98 SPOKANE COUNTY — BUILDING CODES DEPARTMENT L`& 6 E
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /a—.2` 79
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
02 * * 220. 00
JOB ADDRES , A
6�, L} LEGAL DESCRIPTION — SEE ATTACHED * 2 2 Q 0 0 n
2 IfO K SUBDIVISIONps 71:2 rj
OH PARCEL NUMBER/S y�/4 I Off/ 23 _ ,2 3 * 2 2 O.0 0
E
3. OWNER I MOO �r196 74t 860 66672 * 0. 00
ADDRESSII'30 I .t �rI7No , I Z ��I�j North Requi .. 0
Set BaclSouth Feetks in East 3 (West I C 1 0-2 5 7 9
CONT? TQR PHONE Size of Parcel Zone Classification
��V/�I rrJA 80 x I Pj -it.161L.6 g 611.79.
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation ` Building Area in Sq. Ft.
5' ADDRESS ZIP ' DWL B�eme�A�� Garage Area Storage
CHANGE OF USE FROM TO SplitEntr Spl Level Rancher
6.
c'� No. Baths No. Floors No. Rooms Rec. Room
ill t NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF -
TLD. ❑ PLMB. ❑ MECH: CIM.H. ❑ POOL ❑ OTHER CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK, of EXEMPTION
DESCRIE WORK
$ H Va J E'I y '� ` l i L'/ FEES COLLECTED
VALUATION VI-� 'SSourrce l GAS ELECTRIC WATER SEWER
of
9. 3� 13.610 Utilities —
—
Go pL. c, Single $
I hereby clertify 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 220.
type of work will be complied with whether specified herein or not. The granting •f a permit does not presume
to give authority to violate or cancel the provisions of any other state or I. al law4, s lating construction or the
performance of construction. (tn 41
L (j Plumbing
DATE C ." Z? ."..11 4` SIGNATURE {Y1`(p_ . -t„��\/1y,1
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env. Health •
Q
lD a-5-7, SEPA o
Planning — 1�
a_
Mobile Home Cr)
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
1 WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist j 4-/ THIS BECOMES A PERMIT.
DATE � OFFICIA��-=� _�-e '' !'-.`- ..4-ri - u - ! i �.. i * 2C U, a
---2 /-
APPROVED FOR ISSUANCE _
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