1979, 12-18 Permit: 79-9265 Duplex PLAN NUMBER APPLICATION/PERMIT PEF7(V1ITWUK/BER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT -RJ d12-65
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE Z—I S 'l
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
02 * * 328. 00
JOB ADDRESS
1. E. /0'714'3 6'7 20 II i14 AVE— LEGAL DESCRIPTION - SEE ATTACHED * 3 2 8 0 0
LOT BLOCK SUBDIVISION PARCEL NUMBER/S amker .2'f5 t/..2003 * 2 0
2. 3 W ALLAC.E. Ft,RST AoOrTLON T
OWNER �y'+ PHONE E Q 0 C -'
3. RocADDRESS
kVLLII A SL�
—4 5-ZIP Required f acks I in Feet '� 42-1 Z _ / 9264 -2
Se BB
E Soo $ .3 AD (ktlKA
c_ s poN Y2 DL North South [East West 1 2- 1 8-7 9
CONTRACTOR PHONE Size of Parcel Zone Classification
Rrr'r"W p�[FI 'piEkt 3- - $+-c.,014 -rUrThN `12S�-2344 //o' k 'Two FAw1RE
tI Ly 3. 2 6.4 7 9.
4' ADDRESS C� /� ZIPType Const. OccupancynlSprinkl red
E. 10/2.`, 1 EI��T D�I)E �POpkAW ,12_ V`N 12--.7 ❑Yes No ❑ Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.
3040 _
5. ADDRESS ZIP DWL Area Basement Area Garage Area Storage
U>12)0 eaSo 48/� 64-
CHANGE OF USE FROM TO Split Entry Split Level I Rancher
6. ")C
,�/ No.Baths No. Floors No. Rooms Rec. Room
TYPE L'lNEW ❑ ALT. ❑ AD'N. ❑ RPL. 0 MVE.
7. OF CI OTHERPt< Req'd. Rec'd. Not R�q'd_
WORK
BLD. 0 PLMB. D MECH: 0 M.H. ❑ POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
8. , — :d_: . ►. .' ► GAA L'C-.l .►
VALUAT N Source GAS ELECTRIC WATER SEWER
p of
9. 6s�t�- Utilities B,13. SEPTIC., 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 1328%
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 or local law regulating construction or the
performance of cons ruction. • Z-64% Plumbing
DATE ' 2I $ —7SIGNATURE w Mech. .
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. om Mtcf sCIP
Plan Check
Env. Health C'? /2/7/79IZI , '7
W SO SEPA
Planning re-r ESA-ek. gEY0t'W FLOOP i7aEt - 2
Mobile Home Cl)
Fire Marshall
Co. Engineer Other (Specify)
utilities „.,6 00
TOTAL $3
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist PLANS o'€.7,4 THIS BECOMES A PERMIT.
DATE/G"1�/JT OFFICIA yam, 12 _1.8 -7.9
APPROVED FOR ISSUANCE - .
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