1979, 10-01 Permit: 79-5077 Garage Addition PLAN NUMBER 1 APPLICATION/PERMIT PERMIT NUMBER"
e-`Z r 1 SPOKANE COUNTY — BUILDING CODES DEPARTMENT 7' o 7 2
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509) 456-3675 DATE /(-)-/- 7V
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
02 * * 7450
JOB ADDRESS LEGAL DESCRIPTION - SEE ATTACHED
1. e ; „'7%) ..' rra , .7-H ('-('-'"-Iii _ * 74.50
LOT BLOCK SUBDI�ISION PARCEL NUMBER/S a.51- -3,3- —Q g-1-.5--L7�jzG-
r'_� y 74,50
2-I',4..I i '3..) Y2id, .P'.LJ �/� " PHONE 0(.49 77--S /8THRU.,! 0E * � 0 0 v
OVVER ESR •y Qf// y /d
I./1.'t..."�r,4i
di
3. i \] t./7/1-C.:)0.77 �c3ETT.ti,4NS .4 oD
3 ADDRESS , ZIP Required Set Backs in Feet i 5 0 7,6 2
J <.G1 t /:=d % '-' L'�-<' L,('_d lt.� '�i.<?_... 1`f` 7--` North tJ (South ��' East X34 West /S 1 0"0 1 —7 9
CONTRACTOR 7_ PHONE Size of Parcel Zone Classification
4. Atiff/✓4�;<f_ 13 5' v, -oc..) 1 J A. 2 6,4 7 9,
DDRR "1ESS ZIP Type Const. Occupancy �S,plrrinklered
i/n. -.L.L'' // ... 1 ❑Yes k vo ❑ Req'd.
DESIGNER PHONE Valuat'on Building Area in Sq. Ft.
54 (l /C?L'1C /GIGO 5. ADDRESS ZIP DWL Area I Basement Area Garage Area. Storage
/ ODD
CHANGE OF USE FROM TO Split Entry lit ev I Rancher
6.
No. Baths No. Floors No. Rooms ooms Rec. Room
TYPE CI NEW El ALT. AD'N. ❑ RPL. ❑ MVE.
7, OFAl/BLD.
�./ ❑ OTHER -
CERTIFICATE Req'd. Recd. Not Req'd.
WORK .I� BLD. ❑ PLMB. ❑ MECH: ❑ M.H. CI POOL
of EXEMPTION x.
DESCRIBE WORK r,,Le:L-;&' 2/ ` , FEES COLLECTED
9.
VALUATIONSourceoGAS I ELECTRIC WATER SEWER
d D
Utilities
9. /. / �f7 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
type of work will be complied with whether specified herein or not. The . anting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or kcal law r:,. ing construction or the
Plumbing
performance of construction. II
DATE 9"/9 7-'- ' SIGNATURE 1 _ .- . - --------- Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. REC'D. Plan Check
Env.Health "1 - ;, ' cx
-- C 6t_-e: L i t.("` SEPA o
U
w
Planning — d
Mobile Home
—
Fire Marshall
Co. Engineer Other (Specify)
Utilities
TOTAL $ 77
Zone Clearance
l WHEN MACHINE VALIDATED IN THIS SPACE,
j THIS BECOMES A PERMIT.
SEPA Checklist �f/ / r 1 ,7 l c_ `-c ) !r �- H
/ OFFICIAL ,L /;-`' L.�r_ -- i U i
APPROVED FOR ISS ACE _
_76 V' H1 r/
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OS` , 3►�1'3'fr/s�'�/ '2/
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THIS AREA FOR USE BY APPLICANT FOR LEGAL .
TAX SEGREGATION APPLICATION FORM DESCRIPTIONS AND DRAWINGS. USE REVERSE SIDE IF
NEEDED.
(Applicable to the division of one or more parcels of real property into
two or more parcels under different ownerships, also applies to ''i
aggregation of parcels.) y%�`
NAME 1(sc,[xi..l/ .. I Ped---1,2 4- 'L
r
ADDRESS in 0 7 J r (, .,.)P , sZ,p4-1 `..L_ a9-x.2.6 c 7 y
PHONE NUMBER 4j1—E)C, '7 DATE. i,-, �9 77
DELINQUENT !'/ /0 p_. ..2 „%'
TAXES PARCEL NO(S) �`f o�� �,, %.- �. .i `_
08,A
c''L.,;-:� --! ` . ,,,
I. Enter legal descriptions of all portions to be segregated. Also
include legal description of portions remaining (use supplemental
sheet if needed).
II. Make drawing of entire property. Indicate approximate dimensions
of all property lines. Indicate on which portions of property any
buildings should remain. If a copy of a survey is available, please
attach to this form.
III. This application is to be completed in its entirety before processing.
NOTE: The approval of this application by the County Assessor or his
appointee shall not be construed as authorizing the division of lands for
the purposes of s subdivision in violation of RCW 58.17 (Plat and
Subdivision Act). T tax y is hereby advised that no segregation
will takepla unt' this for completed.
( . , ..
S S
Applicant Signature ti O
•
6161. ;:t_ (°7-4