1979, 08-27 Permit: 79-2935 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER 1
/52 SPOKANE COUNTY — BUILDING CODES DEPARTMENT TT- 24135
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675 DATE / Czi 2 / OM
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES 0 2 * * 5 G G 0
JOB ADDRESS LEGAL DESCRIPTION — SEE ATTACHED * 5�.0 0 u)
,.b. I I ��7
LOT BLOCK CIBDIVISION PARCEL NUMBER/S ���0� �y 2,1,44___qj� 0 * 5 0 0 U
2. �- I c y F 7 1�12 01 6N r„,..,,,OH `�r �/V
OWNER PHONE
B *0.( 0 0
3. A• l� 9 ,-�I�-
ADbESS ZIP / _ RPS '=—ed Set Backs in Feet�J 2 9 3 4 o n
3- Z �0� �o- C!J North 'South 37 lEast IWest2� 0 O—2 7—7 9
CONTRACTOR,1 PHONE Size of Parcel Zone Classif' ation
4' ADDRESS ZIP Type Const. Occupancy Sprinklered
3(V ICS-3 ❑Yes g,No ❑ Req'd.
DESIGNER i PHONE Valuation /( C Building AAl i-F4 t —
5' ADDRESS ZIP IQDyVL AreA triBasremakiA6r Garage Area I Storage
CHANGE OF USE FROM TO Split Entry S it Le Rancher
6.
TYPE ❑ RPL. No. Maths No. Floors No. Rooms Rec. Room
( /NEW 0 ALT. 0 AD'N. 0 MVE. I 3'— rj�
7, OF �7// ❑ OTHER Req'd. Recd. Not Req'd.
WORK 1b OLD. 0 PLMB. 0 MECH: 0 M.H. ❑ POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK
$ t , y 1i 1-6 1 / FEES COLLECTED
VAIr UATI y N S urce GAS ELECTRIC M WATER SEWER
,i SEK- Single $
of iY+Jrl il,/ (y�jlV✓� I6
Q, Utilities �[
I hereby cehtify that I have read and examined this application and have read the "NOTICE" provisions included .p
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 Plumbing.f construction. (-----) g
DATE P / 7 SIGNATURE i( Q, -0 - Mech.
t
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health �} ry
i�j{AJ/ 87/x' 7/79‘/ SEPA
Planning V_ U
1
Mobile Home 7
Fire Marshall -"'
Co. Engineer Other (Specify)
Utilities TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN THIS SPACE,
/i ' THIS COME, A PEA3MIT. o /) O J
SEPA Checklist _ '1, _'J _ '2` '9 3 5 - * 5 4 0 0 fl
DATE -� - _ OFFICIA�" '7. 4. f./ �,� -,' L,.
APPROVED FOR ISSUANCE —
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