1979, 10-25 Permit: 79-6672 Residence APPLICATION/PERMIT PERMIT NUMBER 1
PLAN N
MBER
1("' 3q6 I SPOKANE COUNTY - BUILDING CODES DEPARTMENT 7'7-( 7-
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /4-24-7i
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 2 * * 2 2 G,0 0
JOB ADDRESS
1. 5 LEGAL DESCRIPTION - SEE ATTACHED * 2 2 0 0 0
2. y;✓r✓f� ' .z.354.4.-a.2.06 2 2 0,0 0 6
LOTBLOCK S BDIVISION
2. FSI /IoL1� , 7t7l'(I Cor i PARCEL NUMBER/S reIoKi or
OWNER PHONE E * 0.0 0
3. 121\/rrNI rt eV triW9-_$6040 6 6 7, 1
ADDRESS f I ZIP )_� Required Set Backs in Feet ,( 10
� 77I �!j.—� 11-1 </V2—1North 'South East 34- (West 1 0-25-79
CON PHONE Size X ^O ZoneClassification
t
�!/�, 6479.
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
Oyes ❑No D Req'd.
DESIGNER '' PHONE Valuation Building Area in Sq. Ft.
5' ADDRESS , ZIP r pAyea_ Be me A Garage Area Storage
CHANGE OF USE FROM TO C1 SpliG►,E_�ntylr 'NI Sp it Level Rancher
6.
TYPENo. Baths No. Floors No. Rooms Rec. Room
N W D ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7, OF 0 OTHER
D. 0 PLMB. 0 MECH: 0 M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
WORK LLLIII���"'
of EXEMPTION _
DESCRIBE WORK
NIt-460-6 FEES COLLECTED
8. VALVA ION Sourc 1/ GAS E ECTRIC WATER SEWER
3� A of / —
9. goe0 GoI��#L.. _ 1
I Single $
I hereby cell-My 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 -Z
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 r cal I regulating construction or the
performance of construction.
� C Plumbing
DATE '"'"..2:1� tiL { SIGNATURE • Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health !Y
� /D -I \- ?- SEPA a
Planning - a
Mobile Home v)
Fire Marshall —
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
--‘ WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist / / / JTHISBECOMESAPERMIT. n
/` C
7/417', , 1 ', 2 i r; * 2 2 a 0 0 o -
DATE ''-�il' OFFICIALS C 'Z-1_✓1 /. C ti. r-
i
APPROVED FOR ISSUANCE -
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