1979, 10-25 Permit: 79-6666 Residence PERMIT NUMBER
PLAN NUMBER
98 _r�~ APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7.f-((6�,
NORTH 811 JEFFERSON I SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE AO—e2/171-79
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES 0 2 * * 2 2 0 0 0
JOB ADDRE
1. I 4,1 LEGAL DESCRIPTION - SEE ATTACHED * 2 2 0 0 0 t5
LOT BLOCK SUBDIVISION 1 PARCEL NUMBER/S
wi�ER * 2 2 O.0 06
Z. ���G,d0PHON E * O.0 0 v
3, ADDRESSt ' )ri,n9 r" risir ZIP -8600 Required Set Backs in Feet 6 6 6,5 2
(37O) 0. �IpI U Fj 9 '24 Co North 30 (South East '' Iwest 10 1 0-2 5-7 9
CO� PHONE Size of Parcel I fe Zo I i n
,G 2 6.479,
4. `
ADDRESS ZIP Type Const. Occupancy Sprinklerrkfrl
❑Yes ❑No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
5. —
ADDRESS ZIP WL Area Baseme t Are Garage Area Storage
i�5A6tpoi? 5.°2110.
CHANGE OF USE FROM TO Split ntr I Spli Level Rancher
6.
No. Baths No. Floors No. Rooms Rec. Room
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF I ❑ OTHER
WORK BLD. ❑ PLMB. ❑ MECH: ❑ M.H. ❑ POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION
DESCRI E WORK
8. 111/4• 1-
L6 - ^ 1 I� FEES COLLECTED
VAALUATION SSource GAS EL CTRIC LW'ATER SEWER/
9. :.1 8 00 Utilities G°IJ‘oL � G 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 laws and ordinances governing this Building .2.2-Z),
type of work will be complied with whether specified herein or not. Th- grantig• of a permit does not presume
to give authority to violate or cancel the provisions of any other stat local It regulating construction or the
performance of construction. `, 3 Plumbing
DATE W �Z2 =Z ` SIGNATURE •4.
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. DNr ri N j/�� �I/�-h� Plan Check
Env. Health�/i _ �J r/�l�l �C111 fP�'
/?�JSEPA CD
SCD—'�3—'7 i—
Planning — w
3-
Mobile Home (/)
Fire Marshall
Z
Co. Engineer Other (Specify)
Utilities
TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist '0 ti
��f THIS BEICOMESA PERMIT. `
DATE - I/OFFICIAL=-L L-L-c .'�-r. EL2—�_.... �_ ll —'L 5 ( �� ii �. *220. 002r!
APPROVED FOR ISS' NCE -
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