1979, 08-27 Permit: 79-2929 Residence FLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
/51. 2, 71- zfz9
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE Ark-7 91/`aZ`7
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES off, * 5 4,0 0
JOB ADDRESS
LEGAL DESCRIPTION — SEE ATTACHED * 5 t.0 0
LO BLOCK SUBDIVJSIOyN� /, PARCEL NUMBER/S 22/ ",/�L .—�j)�; ,&'.2prep 8 * 0,0 0 S
2. ek ,,a-/ ,L O T / /34/-( ; j 2 9 2 8 8
oNI'ER w PHONE
3, J S i4 CA-'1•764:Z;. q 2:.4WA, aRicKs .5•00 08-27-79
AD-DR S ? ZIP Required
Required Set Backs in Feet / ✓
/s Jam-i ,,IX..4D. -44Ka/ �I9 -U(� North r (South%i. East 15 IWest g R 6479.
CONTRACTOR PHONE Size of Parcel / Zone Classification
i
4. ADARESS ZIP Type Const. Oc,l pancy Sprinklered
/-IC .Y(` , r_ik/ L> .,- Yes A,lo ❑ Req'd.
DESIGNER PHONE Vat4onn /` /� Building Area in Sq. Ft.
ADDRESS ZIP DWL Area� Basement Area Garage Area Storage
g 99.-
CHANGE OF USE FROM TO Split Entry Split Level Rancher
6.
TYPE �I No. Baths No. Floors No. Rooms Rec. Room
KNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7, OF El OTHER L I -
WORK XL BLD. ❑ PLMB. ❑ MECH: ❑ M.H. 0 POOL CERTIFICATE Req'd. Rec'd. Not Req'd.
of EXEMPTION x.
DESCRIBE WORK,
8. -,4- sVC, ,&/2/C4-.- Nz/i,,,-YLA
FEES COLLECTED
VALUATION A i Source GAS ELECTRIC WATER SEWER
t -. of
g, 4'5i ,�J,9 Utilities
Single $ —
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included G
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
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 construction. Plumbing
DATE 8_ / ' /9. SIGNATURE 2, iL------61----Q—C j Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health
'k/ 07/ SEPA 0
Planning — w
7_
Mobile Home `I)
Fire Marshall
Co. Engineer Other(Specify)
UtilitiesQLi
TOTAL $ ��
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist iTHIS BECOMES A PERMIT.
� ", /!' 0 -27- - 79 = 9' ', 9 * 5400 ° f
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DATE vi _. OFFICIAL\ f �
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APPROVED FOR ISSUANCE -
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